Rezhaw Luca Karadaghi*, Thomas Moschidis, Muhammad Zaheer, Marc Huttman and Martin Klein
Department of General Surgery, Barnet General Hospital, Royal Free NHS Foundation Trust, UKFulltext PDF
Intestinal evisceration secondary to trauma to a parastomal hernia is a rare occurrence. Evisceration through a parastomal hernia occurs secondary to overlying skin weakening, direct pressure from a parastomal hernia or in conditions that increase intrabdominal pressure. Evisceration in the context of blunt abdominal trauma is sparse in the literature. A 62-year-old gentleman presented with intra-stomal evisceration of small bowel, secondary to blunt abdominal trauma. Approximately one meter of bruised small bowel had eviscerated. He was resuscitated as per ATLS principles and transferred to theatre within one hour of presentation. A laparotomy revealed a four-centimeter full-thickness tear in the medial colostomy mucosal surface. Viable bowel perfusion was estimated and the bowel was returned into the abdominal cavity. Timely preoperative optimization and rapid transfer to theatre, resulted in an avoidance of bowel resection and associated complications. This case highlights the need for more research into operative assessment of intestinal viability.
Karadaghi RL, Moschidis T, Zaheer M, Huttman M, Klein M. A Rare Presentation of Intra-Stomal Small Bowel Evisceration Secondary to Blunt Trauma to a Pre-Existing Parastomal Hernia. Ann Clin Case Rep. 2022; 7: 2333..