The common factors causing parastomal hernia are weak abdominal wall tissue around the enterostomy (elderly people, patients with multiple abdominal operations), persistent intra-abdominal pressure increase (such as sneezing, coughing, straining to defecate and urinate, etc.), stoma Not placed above the rectus abdominus, the myometrial incision is too large resulting in enlarged or dehiscated opening of the abdominal wall muscle.
Mild ones cause swelling at or around the base of the enterostomy. In severe cases, the small intestine may herniate through the intestinal wall, or cause incarcerated abdominal wall hernia or intestinal obstruction.
Processing method:
Do not lift heavy objects, and restrain the stoma site with both hands when coughing to reduce abdominal pressure.
For single-lumen sigmoid colostomy or single-lumen descending colostomy, if the colostomy is lavaged, the lavage should be stopped.
In the early stage or with mild symptoms, using a suitable abdominal belt or a special stoma belt can reduce the symptoms.
One-piece ostomy bags should be used for ostomy appliances, and two-piece ostomy bags, especially convex ones, should be avoided, so as to reduce the problem of increased abdominal force for patients when filling or manipulating the stoma buckle to seal with the collection bag.
Surgical correction is indicated when the hernia grows further and becomes difficult to care for, or when there is persistent pain, refractory peristomal dermatitis, and risk of bowel obstruction. People with severe abdominal relaxation are more prone to this problem and need special attention.
