Journal article
End-colostomy diverticulitis with parastomal phlegmon: A case report.
- Muradbegovic M aDepartment of General and Visceral Surgery, EHC Hospital, Morges b Department of Visceral Surgery, University Hospital CHUV, Lausanne cUnilabs, Department of Pathology, Lausanne, Switzerland.
- St-Amour P
- Martin D
- Petermann D
- Benabidallah S
- Di Mare L
- 2017-10-26
Published in:
- Medicine. - 2017
Abdominal Neoplasms
Aged
Anus Neoplasms
Cellulitis
Colostomy
Diverticulitis, Colonic
Female
Humans
Perineum
Postoperative Complications
Surgical Stomas
English
RATIONALE
Acute colonic diverticulitis is a well-known surgical emergency, which occurs in about 10 percent of patients known for diverticulosis.
PATIENT CONCERNS
The case of a 77-year-old woman is reported, with past history of abdominoperineal resection with end-colostomy for low rectal adenocarcinoma, and who developed an acute colonic diverticulitis in a subcutaneous portion of colostomy with parastomal phlegmon.
DIAGNOSES
Initial computed tomography imaging demonstrated a significant submucosal parietal edema with local fat tissues infiltration in regard of 3 diverticula.
INTERVENTIONS
A two-step treatment was decided: first a nonoperative treatment was initiated with 2 weeks antibiotics administration, followed by, 6 weeks after, a segmental resection of the terminal portion of the colon with redo of a new colostomy by direct open approach.
OUTCOMES
Patient was discharged on the second postoperative day without complications. Follow-up at 2 weeks revealed centimetric dehiscence of the stoma, which was managed conservatively until sixth postoperative week by stomatherapists.
LESSONS SUBSECTIONS
Treatment of acute diverticulitis with parastomal phlegmon in a patient with end-colostomy could primary be nonoperative. Delayed surgical treatment with segmental colonic resection was proposed to avoid recurrence and potential associated complications.
Acute colonic diverticulitis is a well-known surgical emergency, which occurs in about 10 percent of patients known for diverticulosis.
PATIENT CONCERNS
The case of a 77-year-old woman is reported, with past history of abdominoperineal resection with end-colostomy for low rectal adenocarcinoma, and who developed an acute colonic diverticulitis in a subcutaneous portion of colostomy with parastomal phlegmon.
DIAGNOSES
Initial computed tomography imaging demonstrated a significant submucosal parietal edema with local fat tissues infiltration in regard of 3 diverticula.
INTERVENTIONS
A two-step treatment was decided: first a nonoperative treatment was initiated with 2 weeks antibiotics administration, followed by, 6 weeks after, a segmental resection of the terminal portion of the colon with redo of a new colostomy by direct open approach.
OUTCOMES
Patient was discharged on the second postoperative day without complications. Follow-up at 2 weeks revealed centimetric dehiscence of the stoma, which was managed conservatively until sixth postoperative week by stomatherapists.
LESSONS SUBSECTIONS
Treatment of acute diverticulitis with parastomal phlegmon in a patient with end-colostomy could primary be nonoperative. Delayed surgical treatment with segmental colonic resection was proposed to avoid recurrence and potential associated complications.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1097/MD.0000000000008358
- PMID 29069019
- Persistent URL
- https://sonar.ch/global/documents/246429
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