Parastomal hernia is a type of incisional hernia occurring in the abdominal integuments near a stoma, where abdominal contents, typically the bowel or greater omentum, protrude through the abdominal wall, forming a hernia sac around the stoma.
Despite the lack of a standard definition, in 1973, Devlin proposed a classification system comprising four types of hernias: type I – integumentary (true parastomal hernia); type II – subcutaneous; type III – intra-stomal; and type IV – pseudo pre-stomal.
Parastomal hernia is the most common complication associated with various types of stomas. It can often progress asymptomatically, resulting only in an abdominal deformity near the stoma. However, in severe cases, it can lead to bowel incarceration and strangulation, necessitating immediate surgical intervention. Currently, approximately 1 in 3 patients with this complication undergo surgical treatment, a statistic influenced by the high recurrence rate observed after hernia repair.
Aspect
Description
Definition
A type of incisional hernia occurring near a stoma, where abdominal contents protrude through the abdominal wall, forming a hernia sac around the stoma.
Epidemiology
Occurs in 30-50% of patients with stomas. Higher risk with colostomies compared to ileostomies. Risk factors include obesity, malnutrition, age, and chronic conditions like COPD.
