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Appendix and ascending colon intussusception through a prolapsed transverse colostomy: A case report with literature
Fatimah Abdullah Alquraish1, Arwa Hanafie Ibrahim2, Turki Alshammari3
1Division of Colorectal Surgery, Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Introduction And Importance:
Stoma creation is one of the common performed surgical procedures. For both benign and malignant conditions, in elective and emergency settings. Like any surgical procedure, it is associated with complications. One of the most frequently encountered is prolapse, with the incidence rate reaching 26 %. On the other hand, intussusception of the bowel through the ostomy is a rare complication, with few cases being reported in the literature.
Case Presentation:
We reported a case of 52 years old female with a proximal limb transverse loop colostomy prolapse noted one-day prior to her presentation. Intraoperatively, cecal intussusception through the ostomy is encountered with unsalvageable right colon. The patient ended up with right hemicolectomy, end ileostomy, and mucus fistula.
Clinical Discussion:
Although stoma prolapse is a common late complication with an impact on quality of life in term of difficulty with appliance fitting, it can be an early sign of serious condition like intussusception. This necessitating a differentiation between intussusception through a prolapsed colostomy from simple prolapse. Based on literature, reduced stoma output along with significant irreducible prolapsed segment are the frequent clinical characteristic. Yet it should be noted that intussuscepted segment is only evident upon surgical exploration.
Conclusion:
In conclusion, caution during stoma creation must be attempted, with avoidance of underestimating a significant irreducible prolapse. As it may be associated with an intussusception which may lead to ischemia and bowel perforation.
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