parastomal hernia

Etiology

• end colostomy is associated with a higher incidence of parastomal hernia, compared to other types of stomas

Physical examination

• examination in supine & erect positions & with Valsalva maneuver

Radiology

• abdominal CT or ultrasonography in cases of diagnostic uncertainty

Management

• keep size of fascial aperture as small as possible to allow passage of intestine through abdominal wall without ischemia
• prophylactic synthetic non-absorbable mesh when constructing an elective permanent end colostomy to reduce the parastomal hernia rate.
• for laparoscopic parastomal hernia repair, a mesh without a hole is suggested in preference to a keyhole mesh
• avoid performing a suture repair for elective parastomal hernia

More general terms

• hernia