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End-colostomy diverticulitis with parastomal phlegmon: A case report.
Mirza Muradbegovic1, Pénélope St-Amour, David Martin
1Department of General and Visceral Surgery, EHC Hospital, Morges Department of Visceral Surgery, University Hospital CHUV, Lausanne Unilabs, Department of Pathology, Lausanne, Switzerland.
Medicine
|October 26, 2017
Summary
Acute colonic diverticulitis in patients with end-colostomy can be treated nonoperatively initially. Delayed surgery with segmental resection may prevent recurrence and complications in parastomal phlegmon cases.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Acute colonic diverticulitis is a common surgical emergency affecting approximately 10% of patients with diverticulosis.
- Parastomal phlegmon, a complication of diverticulitis, can occur in patients with a colostomy.
Observation:
- A 77-year-old woman with a history of abdominoperineal resection and end-colostomy developed acute colonic diverticulitis with parastomal phlegmon.
- Computed tomography revealed submucosal edema and fat infiltration around three diverticula.
Findings:
- A two-step treatment approach was employed: initial nonoperative management with antibiotics for two weeks.
- Delayed surgical intervention, including segmental colonic resection and a new colostomy, was performed six weeks later.
- The patient experienced a stoma dehiscence post-surgery, managed conservatively.
Implications:
- Nonoperative management can be a primary treatment for acute diverticulitis with parastomal phlegmon in end-colostomy patients.
- Delayed surgical intervention may be necessary to prevent recurrence and associated complications.
- Conservative management of stoma complications is feasible.
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