Internal hernia of the stomach associated with colostomy after laparoscopic surgery for rectal cancer: a case report

Abstract

Background: Colostomy via the intraperitoneal route is often performed during laparoscopic Hartmann's operation or abdominoperineal resection. Internal hernia of the small intestine often occurs after colostomy. This report shows a rare case of internal hernia of the stomach associated with sigmoid colostomy after laparoscopic abdominoperineal resection for rectal cancer. Case presentation: The patient was a 79-year-old woman with a sigmoid colostomy. Computed tomography scan showed a markedly distended stomach in the space between the lifted sigmoid colon and the lateral abdominal wall. Laparoscopy revealed that the body of the stomach had passed through a hernia orifice located between the lifted sigmoid colon and the left lateral abdominal wall. The dislocated stomach was restored to its normal position, and the lateral defect was closed with the lateral peritoneum and the lifted sigmoid colon laparoscopically. Conclusions: Internal hernia associated with colostomy can lead to not only obstruction of the small intestine, but also obstruction of the stomach. We reported a successful case of the suture repair for the internal hernia of the stomach associated with colostomy.

Post-colostomy internal hernia of the stomach treated with laparoscopic gastropexy: a case report

“…Mesenteric defects often lead to intestinal obstruction and rarely to internal hernias of the stomach. Two cases of internal hernias of the stomach following a sigmoid colostomy have been reported; one was treated by suturing the sigmoid stoma to the abdominal wall [ 3 ], while the other was treated by changing the intraperitoneal route to an extraperitoneal one [ 4 ]. In both cases, an abdominoperineal resection was performed and an end stoma was created.…”

“…Two previous cases reported that a reliable treatment for hernia was to close the aperture surgically [ 3 , 4 ]. It was thought best to perform abdominoperineal resection and the aperture closure surgery at the same time, however, since the patient was undergoing chemoradiation therapy and it was difficult to change the date of lengthy surgery, we decided to perform them separately.…”

“…Internal hernias are most commonly associated with the small intestine and are rarely associated with the stomach. Internal hernias of the stomach comprise parastomal hernias [ 2 ] and post-colostomy internal hernias [ 3 , 4 ]. The stomach dilates after eating and descends into the pelvis through the space between the lifted sigmoid colon and the left abdominal wall.…”

“…Notably, only two cases of post-colostomy internal hernias have been reported. The first case was treated by suturing the sigmoid colon to the lateral abdominal wall [ 3 ], while the second case was treated by changing the intraperitoneal route to an extraperitoneal one [ 4 ]. Both treatments are for closing an aperture, and the use of gastropexy for treatment has not been reported yet.…”