Parastomal stomach herniation complicated by gastric outlet obstruction: A case report and literature review. (2018)

• Record Type: Journal Article
• Authors: Eastment, Jacques; Burstow, Matthew
• Is Part Of: International journal of surgery case reports. Volume 53(2018)
• Page Start: 273
• Page End: 276
• Publication Date: 2018
• Subjects: Parastomal hernia -- Gastric outlet obstruction -- Stomas, surgical -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2018.10.049
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Gastric outlet obstruction secondary to parastomal herniation of the stomach is rare. It is a disease of elderly females with a history of colostomy or ileostomy formation. Gastric outlet obstruction should be considered in patients presenting with vomiting and a parastomal hernia. Frail or comorbid patients could benefit from non-operative management. Abstract: Introduction Parastomal herniation commonly occurs following formation of an end-colostomy or ileostomy. Those patients presenting with acute complications of parastomal hernias typically undergo surgical repair. Stomach-containing parastomal hernias are rare. Presentation of case A 92-year-old lady presented to the emergency department with vomiting and abdominal pain. She had undergone a total colectomy with end-ileostomy many years earlier. A computed tomography scan of her abdomen diagnosed gastric outlet obstruction secondary to parastomal stomach herniation. The obstruction resolved with simple nasogastric decompression and the patient did not receive surgery. She was discharged from hospital after two days. Discussion Gastric outlet obstruction secondary to a parastomal hernia is rare. A systematic literature search found 12 previously reported cases. This is the first case managed without invasive procedures. Conclusion For gastric outlet obstruction caused by parastomal herniation, surgeons should consider non-operative management with nasogastric decompression when the patient in question is frail and a poor surgical candidate.