A Case of Strangulated Ileus and Stoma Necrosis due to Parastomal Hernia

Abstract

An 89-year-old woman was introduced to our hospital with symptoms of nausea and abdominal pain. She was performed laparoscopic Hartmann's operation for rectal cancer 4 years previously. The color of the stoma was not well slightly when the patient came to our hospital. An enhanced CT scan revealed a parastomal hernia without poor contrast area. Because the patient could not stop breathing during the examination, the images were poor, and we could not identify what the herniated digestive tract was. Therefore, the patient was admitted for follow-up. Because the symptoms did not improve and the stoma gradually became necrotic in 2 days after admission, we performed emergency operation. The content of the hernia was a jejunum 70-90 cm distal from Treitz's ligament with partial necrosis. The stoma was necrotic on the area distal from the hernia orifice. A partial resection of the jejunum, end-to-end jejuno-jejunostomy and end-transverse-colostomy (relocation) were performed. The cases of strangulated ileus and stoma necrosis due to parastomal hernia are very rare. We report on the case with a review of the literature.