Intestinal Extrusion by the Hole of Colostomy

Valdemir Jose Alegre Salles, Carolina Mardegan, Matheus Jose Maia Pereira, Paulo Giovanni Estevam, Raphael Bacco Gusmao da Rocha, Silvia Manprim Padovese, Karla Rachid Pereira, Marcella Camara Moura Silva

Intestinal extrusion developed at the site of a stoma is a rare occurrence, associated with an elevated morbidity-mortality. The clinical symptoms frequently occur between the sixth and seventh postoperative days. The risk factors most commonly related to extrusion are: increased intra-abdominal pressure, cancer of the digestive tract, emergency surgery and stomas in the surgical incision. The authors report the case of male patients, with adenocarcinoma of the median rectus with acute obstructive abdomen, submitted to loop transversotomy with the objective of decompression. The patients presented intestinal extrusion through the peri-colostomic abdominal orifice. This occurred on the tenth post-operative day with a severe picture of Syndrome of Systemic Inflammatory Response and pneumonia. The association of some initiating factors, such as the emergency surgery, the neoplastic colorectal malignancy, the increase of intra-abdominal pressure and the technical error in tailoring the colostomy were determining factors for the development of this peri-colostomic complication.