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Case Reports
. 2020 Jun 25;2020(6):rjaa124.
doi: 10.1093/jscr/rjaa124. eCollection 2020 Jun.

Internal hernia of the stomach through the lateral space of the colostomy: a case report

Kentaro Shinohara  1 , Masahiko Suzuki  1 , Yutaro Asaba  1 , Takao Maeta  1 , Tomoyuki Ishida  1 , Yasunobu Mizukami  1
Affiliations
Case Reports

Internal hernia of the stomach through the lateral space of the colostomy: a case report

Kentaro Shinohara et al. J Surg Case Rep. .

Abstract

An 81-year-old woman had undergone laparoscopic abdominoperineal resection for rectal cancer. A permanent colostomy was created through an intraperitoneal route. Three months after the surgery, the patient presented with lower abdominal pain and vomiting. Computed tomography showed gastric incarceration through the lateral space of the lifted sigmoid colostomy. Although the herniated stomach was reduced by nasogastric tube decompression, the patient experienced a recurrence of gastric hernia shortly thereafter. A laparoscopic operation was performed, and a new colostomy was constructed through an extraperitoneal route. The patient had no hernia recurrence during the 20 months of follow-up after the operation. Gastric internal hernia associated with colostomy can occur as a rare complication. Although reduction of the incarcerated stomach is possible by nasogastric tube decompression, surgical repair of the hernia may be the optimal management to prevent recurrence.

Keywords: abdominoperineal resection; gastric outlet obstruction; internal hernia; stoma-associated complication.

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Figures

Figure 1
Figure 1
Contrast-enhanced computed tomography images of the gastric internal hernia. (a) The stomach is incarcerated through the lateral defect of the lifted sigmoid colostomy (arrow). (b) The stomach (arrowhead) is reduced after nasogastric tube decompression.
Figure 2
Figure 2
Intraoperative findings of hernia repair. (a) The gastric incarceration is not evident in the lateral space of the sigmoid colostomy (arrow) at the time of exploration. (b) The colostomy is reestablished through an extraperitoneal route using the same stoma site.
See this image and copyright information in PMC

References

    1. Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol 2006;186:703–17. - PubMed
    1. Yokota H, Hoshino I, Sugamoto Y, Fukunaga T, Fujimoto H, Matsubara H, et al. . Internal hernia associated with colostomy after laparoscopic abdominoperineal resection. Clin Imaging 2013;37:590–2. - PubMed
    1. Yokoyama Y, Kawai K, Kazama S, Yoneyama S, Tanaka J, Tanaka T, et al. . A case of extraperitoneal stoma-associated internal hernia after abdominoperineal resection. World J Surg Oncol 2014;12:141. - PMC - PubMed
    1. Yasukawa D, Aisu Y, Kimura Y, Takamatsu Y, Kitano T, Hori T. Internal hernia associated with colostomy after laparoscopic surgery for rectal malignancy: a report of 3 thought-provoking cases. Am J Case Rep 2018;19:1488–94. - PMC - PubMed
    1. Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK. AJCC Cancer Staging Manual, 8th edn. New York: Springer, 2016,

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