Ileal loop conduit volvulus: a rare but reversible cause of bilateral ureteric obstruction

Conduit volvulus is a very rare complication of ileal loop diversion. To date it has not been described in association with parastomal herniae. We report two such cases. Antegrade nephrostogram established the diagnosis and nephrostomy drainage facilitated spontaneous resolution of the volvulus with return to baseline renal function in both patients. Percutaneous drainage was the only intervention required in one case. For the second patient, percutaneous decompression permitted elective surgical refashioning of the conduit following clinical stabilization. Conduit volvulus in association with a parastomal hernia is a potentially reversible cause of renal impairment in patients with urinary diversions. The diagnosis depends on accurate radiological evaluation. The initial treatment of choice is percutaneous drainage with elective surgery when the patient's clinical status has improved.