Incarcerated parastomal hernia causing small bowel and ileal conduit obstruction

Case contributed by Dr Chris O'Donnell

Presentation

PH of cystectomy for bladder Ca. Now painful ileal conduit stoma with vomitting. No urine in stoma bag.

Patient Data

Age: 70
Gender: Male

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!

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Case Information

rID: 20253
Case created: 8th Nov 2012
Last edited: 8th Feb 2016
Inclusion in quiz mode: Included

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