Evisceración transestomal: una complicación excepcional de las colostomías

R, Carmen Nofuentes; L, Mario Mella; B, Susana Pérez; S, Edelmira Soliveres; M, Andrés García; G, Salvador García

doi:10.4067/s0718-40262011000500002

Cited by 1 publication

(6 citation statements)

References 3 publications

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“…Knowledge of etiology is paramount for prevention. Previous studies [13,14,[17][18][19][20][21][22][23][24][25]27,28,30,[36][37][38] focused on alleged predisposing risk factors: COPD, cough in the postoperative period; increased intra-abdominal pressure; chronic alcohol abuse, smoking; emergency surgery; advanced age; disseminated cancer, ascites; poor nutrition; immunosuppressive therapy, HIV; and diabetes mellitus. Risk factors (e.g., comorbidities) are associated with any incisional evisceration and are not specific to stoma evisceration; they can not be responsible if a direct, specific, cause is identified.…”

Section: Cause Of Eviscerationmentioning

confidence: 99%

“…Seven different options were used for surgical stoma treatment, demonstrating a high versatility: stoma revision/refashion [20][21][22]24,25,27,28,30,37]; partial resection and recreation of initial stoma [19,29,[31][32][33]; repair of tansstomal defect [14,18,34,35]; repositioning to a new site [15,16,23,36]; conversion to another type of stoma in the same location [12,17]; take-down of temporary ileostomy [13]; and stoma resection [23]. The initial stoma site was preserved in 22/28 case reports (78.57%).…”

Section: Surgical Stoma Treatmentmentioning

confidence: 99%

“…Carmen Nofuentes et al [ 14 ], 2011, reported the case of an 83-year-old male (with a history of senile dementia) who was operated on for rectal ADK (abdominoperineal amputation). Three months after index surgery a late transstomal evisceration of large omentum (LO) was reported.…”

Section: Reviewmentioning

confidence: 99%

“…The eviscerated content varied according to each case report and it was not connected to the type of stoma or mechanism of evisceration: SB (24/28; 85.71%), TC [ 17 , 27 ], SC [ 33 ], LO alongside a hollow viscus [ 23 , 27 , 33 ], or only LO [ 14 , 32 ].…”

Section: Reviewmentioning

confidence: 99%

“…Second: parastomal approach (42.85%), especially for early [ 12 , 17 , 22 , 24 , 27 , 28 , 32 , 37 , 38 ] rather than for late evisceration [ 21 , 33 ]. Third: transstomal approach for a late evisceration [ 14 ]. A local surgical approach (avoiding laparotomy) was used in 13/28 (46.42%).…”

Section: Reviewmentioning

confidence: 99%

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Diverting Stoma-Related Evisceration: A Comprehensive Review of 28 Case Reports Published in the Medical Literature in English

Mateș

2024

Cureus

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Evisceration is an exceptional complication of diverting a stoma (a common procedure, often considered a minor surgery) with peculiar, specific, features (distinct-to-usual incisional evisceration), due to the presence of a stoma. Available data are limited to a few case reports; some aspects are not fully documented. The results of 28 case reports (full-text articles published in the English literature) were analyzed using 14 variables: age and gender; pathology; surgical setting; index surgery and type of stoma; intended stoma creation; time from surgery to evisceration; type of evisceration; visceral content; cause of evisceration; specific predisposing/risk factors; surgical approach; resection of nonviable content; surgical stoma treatment; and short-term outcome. Urgent surgery resulted in 46.42% resection of nonviable eviscerated content and 7.14% mortality.All issues (some not discussed in previous reviews) were analyzed, to highlight their clinical relevance for surgical practice. The mechanisms (types of evisceration) are different in parastomal and transstomal/intrastomal evisceration; they should be considered as distinct entities. The real (underlying) etiology was identified in 26/28 case reports (92.85%): surgical failure, such as inadequate technique/tactics/strategy (12/26 case reports, 46.15%); trauma (7/26 case reports, 26.92%); and spontaneous necrosis (6/26 case reports, 21.42%). Parastomal hernia and/or prolapse (10/28 case reports, 35.71%) were specific predisposing factors; in such cases, early surgical treatment is recommended.Temporary stoma was a potential risk factor, both for early as well as for late evisceration (e.g., longstanding temporary stoma); in such cases, early take-down or conversion to definitive stoma is beneficial. A local surgical approach (avoiding median laparotomy) was used in 13/28 (46.42%) of case reports. Seven different surgical options were used for surgical stoma treatment, demonstrating versatility; the initial stoma site was preserved in 22/28 (78.57%) of case reports.

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