Abstract
Introduction: Appendicostomies have been utilised for provision of antegrade colonic enemas in adults suffering from chronic constipation. Some late complications from appendicostomies include infection, stenosis or structuring causing difficult intubation and revision requiring other stoma formation.
Case: A 48 year old female presented as an emergency admission with sudden-onset of periumbilical central abdominal pain associated with failure to intubate her appendicostomy. Performed 7 years ago for slow transit constipation. Clinical examination revealed a non-distended abdomen with umbilical region tenderness associated with a palpable lump. Abdominal computed tomography (CT) revealed a para-appendicostomal hernia within the umbilicus containing omental fat. A laparoscopic mesh repair was performed after the patient continued to fail self-intubate her stoma. The mesh was cut into a circular disc shape before a key-hole type midline slit was made to accommodate the appendix. After successfully self-administering an anterograde enema post-operatively the patient was discharged home and seen at six weeks where she remained well with no evidence of recurrence, infection or seroma formation.
Conclusion: There are a handful of para-appendicostomal herniae reported in the literature. We present our experience of a laparoscopic mesh repair of such a case in an adult patient, who successfully continues to use her appendicostomy.
Case: A 48 year old female presented as an emergency admission with sudden-onset of periumbilical central abdominal pain associated with failure to intubate her appendicostomy. Performed 7 years ago for slow transit constipation. Clinical examination revealed a non-distended abdomen with umbilical region tenderness associated with a palpable lump. Abdominal computed tomography (CT) revealed a para-appendicostomal hernia within the umbilicus containing omental fat. A laparoscopic mesh repair was performed after the patient continued to fail self-intubate her stoma. The mesh was cut into a circular disc shape before a key-hole type midline slit was made to accommodate the appendix. After successfully self-administering an anterograde enema post-operatively the patient was discharged home and seen at six weeks where she remained well with no evidence of recurrence, infection or seroma formation.
Conclusion: There are a handful of para-appendicostomal herniae reported in the literature. We present our experience of a laparoscopic mesh repair of such a case in an adult patient, who successfully continues to use her appendicostomy.
| Original language | English |
|---|---|
| Article number | 1065 |
| Pages (from-to) | 44 |
| Number of pages | 1 |
| Journal | British Journal of Surgery |
| Volume | 106 |
| Issue number | S6 |
| DOIs | |
| Publication status | Published - 30 Sept 2019 |
| Event | Association of Surgeons in Training International Surgical Conference - Belfast, United Kingdom Duration: 22 Mar 2019 → 24 Mar 2019 |