Parastomal hernia

Case contributed by David Cuete
Diagnosis almost certain

Presentation

History of colon cancer surgery

Patient Data

Age: 60 years
Gender: Female

CT abdomen and pelvis

ct

In the abdomen, the liver is of normal size and morphology, presents a marked decrease in attenuation coefficients of the parenchyma, consistent with fatty infiltration. Under these conditions, no solid focal lesions are identified.

Post-surgical changes with a descending colostomy in the left flank, which has a parastomal hernia containing greater omentum and transverse colon loops without signs of current complication. Another incisional hernia infraumbilical broad-based, uncomplicated.

In the right kidney, is observed a  staghorn calculus partially fragmented in the upper pole, with an area of ​​focal caliectasia. Associated with the above, there is marked cortical atrophy.

No obvious pelvic lymphadenopathy, retroperitoneal or mesenteric. Anteverted uterus with uterine fibroids.

Case Discussion

The parastomal hernia is an incisional hernia related with an abdominal stoma in the abdominal wall.

The stoma may be ileostomy or colostomy. The stomal hernia or paracolostomy is most common late colostomy complication.

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