Incarcerated parastomal hernia causing small bowel and ileal conduit obstruction
PH of cystectomy for bladder Ca. Now painful ileal conduit stoma with vomitting. No urine in stoma bag.
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Parastomal ileal conduit hernia containing a small bowel loop producing both a mechanical small bowel obstruction (dilated small bowel entering the hernia and collapsed bowel leaving) as well as extrinsic compression and kinking of the conduit at the level of the abdominal wall musculature producing marked distention of the conduit and ureters due to backpressure. Once the surgical registrar placed a finger in the stoma and pushed (with some pressure) on the hernia, there was a sudden prolonged gush of urine!