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Symptomatic gastric involvement in a parastomal hernia: uncommon presentation
Maaike Vierstraete1, Dirk Van de Putte1, Piet Pattyn1
1Department of Surgery, Ghent University Hospital, Ghent, Belgium.
Acta Chirurgica Belgica
|August 15, 2018
Summary
Gastric herniation in a parastomal hernia (PSH) is rare but can cause obstruction. Prompt surgical intervention is recommended for PSH with gastric involvement, as conservative methods often fail.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Parastomal hernia (PSH) is the most frequent complication following stoma creation.
- PSH typically involves omentum or bowel loops, with gastric herniation being exceptionally rare.
Observation:
- This study reports on two female patients experiencing gastric involvement within a PSH.
- Clinical presentation included symptoms suggestive of gastric outlet obstruction.
Findings:
- Computed tomography (CT) imaging, nasogastric decompression, and surgical intervention led to positive outcomes.
- Gastric involvement in PSH is more common in older females with colostomies and often necessitates surgical repair.
- One patient experienced temporary gastroparesis and prolonged hospitalization.
Implications:
- Awareness of potential gastric outlet obstruction due to PSH is crucial in patients with obstructive symptoms.
- Surgical treatment is generally preferred over conservative management for gastric PSH due to higher success rates.
- Timely surgical intervention may potentially decrease postoperative hospital stays and the incidence of gastroparesis.
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