Three cases of parastomal hernia causing ileus

Abstract

Case 1 : A 74-year-old female with a colostomy was admitted due to abdominal pain. CT scan revealed her a parastomal hernia along with an ileus : Simple closure of the fascia defect was performed via an intraperitoneal approach. Case 2 : A 79-year-old female with a colostomy was admitted due to abdominal pain. During emergency surgery, the orifice of the hernia was found to be inside the stoma, and incarceration of the intestine was noted. The orifice, which lacked fascia, was simply closed. There was no recurrence in either of the two cases after surgery. Case 3 : An 83-year-old male with an ileal conduit developed an ileus secondary to a parastomal hernia of the conduit. The orifice of the hernia was closed using a composite mesh. The patient developed an infection in the membrane 3 years after the operation. He refused surgery. The patient was conservatively treated and a fistula developed. An artificial mesh should be used with care. The simple closure of a fascia defect is adequate to repair a parastomal hernia if the fascia defect is not very wide.