Premium
CT evaluation for ‘quiescent’ herniation following closure of diverting loop ileostomy
Author(s) -
Saeed Z. M.,
LloydEvans J.,
Reid T. D.,
Williams R.,
Robinson M.,
Williams G. L.,
Stephenson B. M.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2012.03039.x
Subject(s) - medicine , ileostomy , asymptomatic , abdominal wall , hernia , surgery , abnormality , radiological weapon , stoma (medicine) , radiology , general surgery , psychiatry
Abstract Aim The prevalence of abdominal wall herniation at the site of a previous temporary stoma is uncertain. This cohort study investigated the frequency of radiological abnormalities at the site of a closed diverting loop ileostomy. Method All patients in whom an ileostomy was raised and later closed during a 5‐year period formed the study group. When colorectal cancer surveillance computed tomography (CT) was undertaken the images were scrutinized and graded as to defined anatomical abnormalities. Results One hundred and seventy‐nine patients had an ileostomy, of which 92 were diverting. Fifty‐nine (64%) were closed at various intervals (median time to closure 6 (2–22) months and 43 underwent a surveillance CT at 1–3 (median 2) years. At 1 year an abnormality (atrophy or defect) at the site of closure was seen in 16 (37%) CT scans. These were more frequent with increasing duration of follow‐up. One asymptomatic hernia was detected at 2 years but there was no deterioration in the abdominal wall at 3 years when compared with that at 2 years. Conclusion Abnormalities in the abdominal wall at the site of a closed diverting ileostomy are common but true herniation is unusual. The routine use of prophylactic mesh at ileostomy closure may be unnecessary.