– May 10, 2022-

Parastomal hernias are the most common complication around colostomy.

Common factors that cause parastomal hernia are weak abdominal wall tissue around the colostomy (older people, those who have had multiple abdominal operations), persistent intra-abdominal pressure (such as sneezing, coughing, forced defecation and urination, etc.), stoma. It is not placed over the rectus abdominis, and the sarcolemma incision is too large to widen or dehiscence the opening of the abdominal wall muscle.

Mild cases cause bulging at or around the base of the colostomy. In severe cases, the small intestine will herniate through the intestinal wall, or cause an incarcerated abdominal wall hernia or intestinal obstruction.

Processing method:

Do not lift heavy objects, and use both hands to restrain the colostomy site when coughing to reduce abdominal pressure.

For single-lumen sigmoid colostomy or single-lumen descending colostomy, if colostomy lavage is performed, lavage should be stopped.

In early or mild symptoms, the use of a suitable abdominal girdle or a special stoma girdle can relieve symptoms.

One-piece ostomy bags should be used for stoma appliances, and two-piece ostomy bags, especially convex ones, should be avoided, so as to reduce the problem of increasing the patient’s abdominal force when filling or operating the stoma buckle to seal the collection bag.

Surgical correction is required when the hernia is further enlarged and difficult to care for, or when there is persistent pain, refractory dermatitis around the stoma, and risk of intestinal obstruction. People with severe abdominal relaxation are more prone to this problem and need special attention.