Intestinal protrusion by parastomal abdominal rupture as a late complication following colostomy - A case report

Late complications following colostomy include stenosis, parastomal hernia, and intestinal prolapse (protrusion of the bowel through the stoma). We report a very rare complication of small intestinal protrusion due to parastomal abdominal rupture. A 86-year-old man who had undergone emergent Hartmann's procedure for ileus due to sigmoid carcinoma in August 1997 was ambulatory without recurrence or complication in December 2002. He was seen for severe abdominal pain and an abdominal rupture was found in the parastomal area located on the left flank, developing into prolapse and strangulation of the small intestine necessitating emergency resection of the strangulated intestine and recolostomy. Wound infection developed near the stoma postoperatively, but was alleviated conservatively. Late complications of small intestine protrusion through a parastomal abdominal rupture has not, to our knowledge, been previously reported in Japan. It is important to recognize this complication, however, due to its potential mortality.