Parastomal Evisceration: Rare Complication after Total Abdominal Colectomy

Incidence after ileostomy has been described in four previous case reports, occurring at variable postoperative time points ranging from nine days to several months after the original surgery.1-4 We present a case of a 90-year-old gentleman with a history of atrial fibrillation and coronary artery disease who presented to our institution with a one-month history of increasing abdominal distension, leukocytosis with a white blood cell count of 31 x 103/mm3, intermittent diarrhea, and CT scan findings concerning for colonic obstruction, with the transverse colon measuring 10 cm. Review of the other four cases in the literature demonstrates wide variability in the patients who may develop this condition, ranging from a 23-year-old Crohn's patient with historic ileostomy presenting after assault to the abdomen to a 65-year-old male 10 days post-LAR for a precancerous lesion.1- 2 Ours and the other limited cases in the literature highlight the importance of emergent surgical intervention when this rare complication occurs.