Related Experiment Video

Updated: Mar 19, 2026

Author Spotlight: Developing a Rat Model for Pouchitis Research and Treatment
04:05

Author Spotlight: Developing a Rat Model for Pouchitis Research and Treatment

Published on: May 31, 2024

964

A case of surgically treated peristomal pyoderma gangrenosum in a patient with rheumatoid arthritis

Masoomeh Khajehnoori1, Tim O'Brien2

  • 1Department of General Surgery, University Hospital, Barwon Health, Geelong, VIC, Australia, masoum22@hotmail.com.

Journal of Surgical Case Reports
|June 16, 2016
PubMed

Insights

Peristomal pyoderma gangrenosum (PPG) is a rare, painful ulcer condition near abdominal stomas, often linked to inflammatory bowel disease. This case report details a unique surgical intervention for PPG in a rheumatoid arthritis patient, highlighting diagnostic and treatment challenges.

Area of Science:

  • Dermatology
  • Gastroenterology
  • Surgical Pathology

Background:

  • Peristomal pyoderma gangrenosum (PPG) is a rare, aggressive ulcerative condition affecting the skin around abdominal stomas.
  • It is frequently associated with inflammatory bowel disease (IBD) and presents diagnostic and therapeutic challenges.

Observation:

  • A 56-year-old female with rheumatoid arthritis developed a rapidly progressing, necrotic abdominal ulcer post-Hartmanns procedure.
  • The ulcer formed a large cavity with fecal contamination, mimicking other ulcerative conditions.

Findings:

  • Differential diagnoses including infections (Mycobacterium ulcerans, AFB) and other ulcerative causes were excluded via histopathology and PCR.
  • The patient was diagnosed with PPG, a condition typically managed medically due to surgical risks.

Implications:

  • This case highlights the rare but critical consideration of PPG in peristomal ulcerations, even in non-IBD patients.
  • Despite standard treatment protocols, surgical debridement was deemed necessary due to the risk of fecal peritonitis, showcasing a deviation from typical management.
  • The report emphasizes the importance of a multidisciplinary approach for complex PPG cases, balancing medical and surgical interventions.

More Related Videos

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis07:22

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

1.3K

Related Concept Videos

Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
1.6K
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
818
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
775
Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
1.1K
Staphylococcal Skin Infections01:29

Staphylococcal Skin Infections

Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
4
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
1.5K