Paracolostomy hernias: what are they and why do they happen?

What is a colostomy?

A colostomy refers to the removal of part of the large intestine (colon) through a hole in the abdominal wall, so that faecal matter produced by the body has to be collected in a bag. It can be permanent or temporary.

A paracolostomy hernia happens through the formation of a hole in the abdominal wall, meaning the colon now passes through the hole, and over time, the hole becomes becomes larger and passes not only the colon but other intra-abdominal structures (herniation).

Paracolostomy hernia symptoms

The symptoms of a pericolostomy hernia are the same as a hernia in other locations:

• appearance of a lump at the point of occurrence
• pain
• possibility of hernia strangulation
• particularly in this type of hernia, problems with how the colostomy performs, since the hernia can compress it

Treatment for paracolostomy hernia

In temporary colostomies, the ideal is to "remove" the colostomy, reconstruct (splice) the colon and restore normal intestinal transit, then close the hernia on the abdominal wall, reinforcing it with a mesh.

In cases of permanent colostomies you cannot close the hole (only treat the hernia), thus running the risk of a new hernia developing in the future.

A successful technique to treat the hernia is a mesh that covers it from within the abdomen by using laparoscopy (keyhole surgery) with small incisions, which means the surgeon does not create a new incision that can be broken (eventration).

This treatment has several advantages: a new large incision is not made, the colostomy is not touched (less risk of infection of the mesh) and the mesh is placed from within the abdomen, which is where the hernia has formed. This treatment has been designed to last indefinitely, so no replacement or repeat procedure should be necessary. 

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