1.4.6 Parastomal hernia
Parastomal hernias are hernias occurring beside (Greek term para = beside) an artificial intestinal outlet (stoma). The opening in the abdominal wall, which is needed to construct the stoma, serves as the hernia opening through which the hernial sac, possibly with parts of the intestines or greater omentum, protrude outwards. Up to 50 % of all stoma patients are affected by a parastomal hernia, thus making it the most common complication associated with an artificial intestinal outlet.
A parastomal hernia occurs if the scar in the region of the stoma (opening) is not sufficiently strong. Contributory factors are impaired wound healing, bleeding and wound infections, in addition to the patient’s poor general and nutritional status, special diseases such as diabetes or cancer, overweight, medications (in particular cortisone preparations), long-standing nicotine consumption as well as defective collagen metabolism. The symptoms of a parastomal hernia are palpable defects in the affected tissue or a protrusion in the region of the artificial intestinal outlet, occurring when coughing or pressing.