Venous ischaemia in a colonic stoma
PH Abdomino-perineal resection for low rectal cancer (years ago). Now stoma is not working has developed severe abdominal pain. Stoma is swollen.
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Circumferential oedema of the colon as it passes thorugh the muscle of the anterior wall up to the stoma with oedema in the surrounding fat. Back-up faecal distension of the colon proximal to the stomal oedema.
The colon is effectively "strangled" as it passes through the abdominal wall musculature causing secondary mural odema and luminal obstruction due to venous obstruction.