Spontaneous rupture of a parastomal hernia with evisceration of small bowel: a case report

• Published in: BMC surgery 2019-04, Vol.19 (1), p.43-43, Article 43
• Main Authors: Basnayake, Oshan, Jayarajah, Umesh, Jayasinghe, Jayan, Wijerathne, Pradeep Kumara, Samarasekera, Dharmabandhu Nandadeva
• Format: Article
• Language: English
• Subjects: Abdomen; Case Report; Case reports; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Colostomy; Colostomy - adverse effects; Complications; Cough; Evisceration; Hernia; Hernias; Hidradenitis Suppurativa - surgery; Humans; Incisional Hernia - pathology; Incisional Hernia - surgery; Intestinal Diseases - pathology; Intestinal Diseases - surgery; Intestine, Small - pathology; Intestine, Small - surgery; Lung diseases; Male; Middle Aged; Obstructive lung disease; Ostomy; Parastomal hernia; Patients; Perineum; Perineum - surgery; Prolapse; Pulmonary Disease, Chronic Obstructive - complications; Quality of life; Respiratory tract diseases; Rupture; Rupture, Spontaneous; Rupturing; Sigmoid loop colostomy; Skin; Skin & tissue grafts; Skin Transplantation; Small intestine; Spontaneous rupture; Strangulation; Surgery; Surgical Stomas - pathology
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-019-0509-5

Long standing ostomy related complications such as parastomal hernia and stoma prolapse may be at a higher risk of developing spontaneous rupture and evisceration, especially in patients suffering from chronic cough. Such patients may need early refashioning of the stoma to prevent this serious complication. Parastomal evisceration is a very rare complication of stomas and to date, only few cases have been reported in the literature. A 51 year old patient with chronic obstructive pulmonary disease (COPD) and extensive hidradenitis suppurativa of the perineum underwent a temporary defunctioning loop sigmoid colostomy and subsequent perineal skin excision and skin grafting. The ostomy was complicated by a parastomal hernia and stoma prolapse 6 weeks post operatively. Five months later he developed spontaneous rupture of parastomal hernia and evisceration of small bowel. Urgent surgery was done and reduction of small bowel loops and re-siting of the sigmoid colostomy was done. Parastomal evisceration is an extremely rare life threatening stoma-related complication which requires urgent treatment.