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: During a 5 year period, all patients in whom an ileostomy was raised and later closed 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: 179 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 to 3 (median 2) years. At one year an abnormality (atrophy or defect) at the site of closure was seen in 16 37% of CT scans. These were more frequent with increasing duration of follow-up. One asymptomatic hernia was detected at two 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 uncommon. The routine use of prophylactic mesh at ileostomy closure may be unnecessary.
© 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland
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