A PARASTOMAL HERNIA CAUSING SMALL-BOWEL OBSTRUCTION

A parastomal hernia is an incisional hernia that occurs at the site of an intestinal stoma on the abdominal wall. We report the case of a 52 -year-old woman who had had ulcerative colitis and a total colectomy a nd ileostomy 9 years before being evaluated for a 2-year history of in termittent small-bowel obstruction thought initially to be due to Croh n's disease. On examination, a clear parastomal hernia was detected an d confirmed by a small-bowel series. At surgery the hernia was correct ed, and her intermittent episodes of small-bowel obstruction resolved. A parastomal hernia should be considered as a cause of intermittent s mall-bowel obstruction in anyone who has a stoma. Careful history and physical examination should suffice in establishing a diagnosis.