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Related Experiment Videos

Refractory parastomal ulcers: a multidisciplinary approach.

H C Wolfsen1, L L Brubacher, C S Ng

  • 1Section of Gastroenterology, Virginia Mason Clinic, Seattle, Washington 98111.

Journal of Clinical Gastroenterology
|December 1, 1990
PubMed
Summary

Chronic parastomal ulcers are rare but treatable. Prompt dermatologic evaluation is key for effective treatment, especially in inflammatory bowel disease (IBD) patients without classic pyoderma gangrenosum.

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Area of Science:

  • Gastroenterology
  • Dermatology
  • Surgical Oncology

Background:

  • Chronic parastomal ulcers are uncommon complications following ileostomy or colostomy surgery.
  • Previous literature suggests causes including infections, fistulas, recurrent inflammatory bowel disease (IBD), pyoderma gangrenosum, and trauma.

Purpose of the Study:

  • To evaluate refractory parastomal ulcers in patients with ileostomy or colostomy.
  • To differentiate causes and treatment outcomes for parastomal ulcers.

Main Methods:

  • Retrospective evaluation of 10 patients with refractory parastomal ulcers over 8 years.
  • Classification of ulcers based on underlying etiology: IBD-related pyoderma gangrenosum versus dermatoses or mechanical causes.

Main Results:

Related Experiment Videos

  • Five patients with IBD and pyoderma gangrenosum required systemic treatment for a mean of 25 weeks.
  • Five patients with dermatoses or mechanical ulcers responded to topical treatment within a mean of 4 weeks.

Conclusions:

  • Parastomal ulcers in patients without IBD or IBD patients without classic pyoderma gangrenosum necessitate early dermatologic assessment.
  • Appropriate local therapy can lead to relatively rapid healing in non-pyoderma gangrenosum cases.