Abdominoplasty for a Crohn Disease Patient Who Had a Colostomy and Significant Weight Loss After Obesity

Patients with inflammatory bowel disease or cancer are often treated using stoma placement. For individuals with a stoma, pouch leakage is the primary problem faced daily. We present a case in which functional abdominoplasty helped improve the patient's quality of life. A 47-year-old woman with a history of Crohn disease, perineal rectal amputation, and colostomy construction presented with significant stomatal leakage. She had previously undergone abscess drainage and stoma replacement due to infection. Preoperatively, the patient could not observe the peristomal area due to excess upper abdominal fat from her history of obesity, making pouch application by herself difficult. It was difficult for the pouch to follow the shape of the surrounding skin owing to abdominal bumps and depressed scarring. Frequent pouch removal caused extensive erosion of the peristomal skin, epidermal peeling, and other dermatologic complications. Postoperatively, abdominal bumps improved, and the peristomal skin was flattened, allowing proper pouch management. The frequency of pouch changes decreased, and the condition of the surrounding skin improved. There are few studies on functional abdominoplasty, with reports indicating that abdominoplasty for individuals with a stoma is associated with a high risk of complications. However, we believe that functional abdominoplasty can contribute to better quality of life for individuals with a stoma by improving pouch application.