End-colostomy diverticulitis with parastomal phlegmon: A case report.

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Serveur académique Lausannois

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info:eu-repo/semantics/altIdentifier/doi/10.1097/MD.0000000000008358

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info:eu-repo/semantics/altIdentifier/pmid/29069019

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info:eu-repo/semantics/altIdentifier/eissn/1536-5964

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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_CA4B55207F219

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Serveur Académique Lausannois

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Université de Lausanne et CHUV

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Abdominal Neoplasms/surgery; Aged; Anus Neoplasms/surgery; Cellulitis/etiology; Colostomy/adverse effects; Diverticulitis, Colonic/etiology; Female; Humans; Perineum/surgery; Postoperative Complications/etiology; Surgical Stomas/adverse effects

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M. Muradbegovic et al., « End-colostomy diverticulitis with parastomal phlegmon: A case report. », Serveur académique Lausannois, ID : 10.1097/MD.0000000000008358

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Acute colonic diverticulitis is a well-known surgical emergency, which occurs in about 10 percent of patients known for diverticulosis. 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. Initial computed tomography imaging demonstrated a significant submucosal parietal edema with local fat tissues infiltration in regard of 3 diverticula. 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. 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. 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.

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