Paraestomal hernia with gastric outlet obstruction: a case report and literature review

Abstract

An 69-year-old obese woman was submitted to an abdominoperineal resection (APR) with left side end colostomy to treat a synchronic sigmoid and middle rectum cancer. Six months after APR, she develop a PH with a progressive increase of the size. The patient refused the surgical indication. Thirteen years after APR she presenting with abdominal pain, hematemesis, bilious vomiting and non-functioning of the stoma in the last 2 days. She had a distended and painful abdomen without signs of peritoneal irritation and a large incarcerated PH. CT showed a PH with incarcerated gastric herniation. Endoscopy showed a 4 cm ulcerated lesion in the lesser curvature of the stomach whose posteriorly histopathological study revealed that it was an ischemic ulcer. She was submitted a correction of PH using an onlay polypropylene mesh put around of the previous stoma. The patient has an uneventful recovery and was discharged 3 days later.

Gastric outlet obstruction due to a parastomal hernia: case report of a robotic‐assisted laparoscopic surgery and literature review

“…The majority of parastomal hernia patients were managed surgically and one patient was reported to be managed non‐operatively due to poor fitness for surgery. Relocation of stoma was identified in four patients while mesh reinforcement was noted to be more prevalent in recent reports with good post‐operative outcomes …”

“…Relocation of stoma was identified in four patients while mesh reinforcement was noted to be more prevalent in recent reports with good post-operative outcomes. [7][8][9][10] Gastric outlet obstruction secondary to a parastomal hernia is rare. Literature review has demonstrated a greater risk in elderly females.…”