Livezey Jonathan B, Bolock Alexa M, Farrell Timothy J
Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
Department of Surgery, Geisinger Community Medical Center, Scranton, PA, USA.
J Surg Case Rep. 2020 Jun 1;2020(5):rjaa067. doi: 10.1093/jscr/rjaa067. eCollection 2020 May.
Although parastomal hernias are a common complication of ostomy formation, herniation of intra-abdominal organs, aside from intestine, is infrequent. Furthermore, herniation of retroperitoneal organs, such as the kidney, is an extremely rare finding. We report the case of a 59-year-old male with a right ileostomy who presented with an acute kidney injury with suggestive urinary tract infection. A computed tomography scan revealed a left proximal ureteral stone with left hydronephrosis and a prominent right parastomal hernia with herniation of the mesenteric/retroperitoneal fat, portion of the right kidney, right proximal ureter and some bowel. The patient was taken to the operating room for a left cystourethroscopy with stent placement and made a full recovery. Due to the patient's extensive surgical history, high risk of postoperative infection and lack of evidence demonstrating functional impairment of the right kidney, surgical intervention was not recommended at the present time.
尽管造口旁疝是造口形成的常见并发症，但除肠道外，腹腔内器官的疝出并不常见。此外，腹膜后器官如肾脏的疝出是极其罕见的发现。我们报告一例59岁男性，有右回肠造口术，表现为急性肾损伤并提示有尿路感染。计算机断层扫描显示左近端输尿管结石伴左肾积水，以及明显的右造口旁疝，疝内容物为肠系膜/腹膜后脂肪、部分右肾、右近端输尿管和部分肠管。患者被送往手术室进行左膀胱尿道镜检查并放置支架，术后完全康复。由于患者有广泛的手术史、术后感染风险高且缺乏证据表明右肾功能受损，目前不建议进行手术干预。
