Colostomy and pericolostomia hernias

The colostomy is the removal of a part of the large intestine (colon) through a hole in the abdominal wall, so that the fecal material comes out and is collected in a bag. It can be definitive or temporary.

A pericolostomy hernia is the creation of a hole in the abdominal wall so that the colon passes through it, which, over time, becomes larger and allows not only the colon to pass through (for which it has been created) but other intra-abdominal structures (herniation). It is said that this is inevitable if a colostomy is worn long enough.

Hernia pericolostomy symptoms

The symptomatology of a hernia pericolostomy is the same as a hernia in another place: appearance of a lump at that level, pain, possibility of strangulation of the hernial content, and particularly in this type of hernias, problems in the correct functioning of the hernia. colostomy, since the hernia can compress the exit of the colostomy.

Treatment

In temporary colostomies, the ideal is to "remove" the colostomy, reconstruct (splice) the colon and re-establish normal intestinal transit, and close the hernia of the abdominal wall, reinforcing it later with a mesh.

In the event that it is definitive, the orifice can not be closed (only the hernia), since it has to pass the colon, which keeps the risk of a new hernia in the future.

The technique that is achieving very good results is the placement of a mesh that covers the hernia from inside the abdomen by laparoscopy (Technique of Sugarbaker by laparoscopy) with small incisions, and not creating a new incision that can be broken (eventration).

This treatment has several advantages: a new large incision is not made, the exit of the colostomy is not touched (less risk of infection of the mesh) and the mesh is placed from inside the abdomen, which is where the hernia.

The placement of this mesh is intended to be durable (forever) so this technique (Sugarbaker) would be indicated in cases of permanent colostomies (forever).