A Parastomal Hernia Causing Small-Bowel Obstruction

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Abstract
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 and ileostomy 9 years before being evaluated for a 2-year history of intermittent small-bowel obstruction thought initially to be due to Crohn's disease. On examination, a clear parastomal hernia was detected and confirmed by a small-bowel series. At surgery the hernia was corrected, and her intermittent episodes of small-bowel obstruction resolved. A parastomal hernia should be considered as a cause of intermittent small-bowel obstruction in anyone who has a stoma. Careful history and physical examination should suffice in establishing a diagnosis.

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