Strangulated ileostomy evisceration following lateralizing mesh repair of parastomal hernia.
Parastomal hernia formation and ostomy prolapse are relatively common complications of intestinal ostomy construction. Underlay mesh placement with lateralization of the stoma limb appears to be the method of repair with the lowest recurrence rate. Prophylaxis of new stomas with mesh is advocated by many authors. We report the case of an 81-year-old man with chronic steroid-dependent COPD who presented to the emergency department with strangulated small bowel evisceration 9 days following completion abdominal colectomy, and creation of an end ileostomy reinforced with intraperitoneal mesh. This rare complication was related to this patient's risk factors for poor healing including poor nutrition, age, chronic COPD and coughing and steroid dependence with immunosuppression.
Division of Colon and Rectal Surgery, Tufts Medical Center, Boston, MA, USA. elie.ramly@gmail.com.
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Ramly
Division of Colon and Rectal Surgery, Tufts Medical Center, Boston, MA, USA.
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Crosslin
Rush University Medical Center, Chicago, IL, USA.
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B
Orkin
Division of Colon and Rectal Surgery, Mount Sinai Hospital, New York, NY, USA.
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Popowich
D000369:Aged, 80 and over; D003371:Cough / Q000150:complications; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012008:Recurrence; D013526:Surgical Mesh; D054047:Surgical Stomas / Q000009:adverse effects*
Colostomy; Ileostomy; Intraperitoneal mesh repair; Parastomal hernia; Stoma–evisceration