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Stoma Prolapse

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Book cover Atlas of Intestinal Stomas

Abstract

Prolapse represents one of the most common late complications involving stomas. Stoma prolapse is categorized as either fixed or sliding. The presentation of stoma prolapse ranges from asymptomatic to incarcerated and strangulated. Primarily, stoma prolapse is a challenge for ostomy care. Numerous factors, both patient-related and technical, have been linked to the development of stoma prolapse. The risk of stoma prolapse is best addressed by a well-constructed stoma. Various modifications to the procedure have been proposed to reduce the incidence of stoma prolapse. For asymptomatic or minimally symptomatic patients, the prolapse can be initially treated by modifying or changing the stoma appliance. A more significant or symptomatic stoma prolapse mandates surgical intervention. A prolapsed stoma may be approached via a local parastomal revision or laparotomy. For a temporary stoma, prolapse is best treated by its reversal. Re-siting of the stoma may become necessary if local revision is unsuccessful. Incarceration and strangulation are uncommon sequelae of stoma prolapse. An incarcerated but viable prolapsed stoma may be initially managed conservatively by reducing the intestinal edema. The appearance of gangrene requires emergent surgical intervention.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA

    Ursula M. Szmulowicz

  2. Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Tracy A. Hull

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  1. Ursula M. Szmulowicz
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Correspondence to Ursula M. Szmulowicz .

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Editors and Affiliations

  1. Digestive Disease Institute, Department of Colorectal Surgery, Cleveland Clinic Foundation, Euclid Ave. 9500, Cleveland, 44195, Ohio, USA

    Victor W. Fazio

  2. Digestive Diseases Institute, Department of Colorectal Surgery, Cleveland Clinic Foundation, Euclid Ave. 9500, Cleveland, 44195, Ohio, USA

    James M. Church

  3. Digestive Disease Institute, Department of Colorectal Surgery, Cleveland Clinic Foundation, Euclid Ave. 9500, Cleveland, 44195, Ohio, USA

    James S. Wu

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Szmulowicz, U.M., Hull, T.A. (2012). Stoma Prolapse. In: Fazio, V., Church, J., Wu, J. (eds) Atlas of Intestinal Stomas. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-78851-7_22

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  • DOI: https://doi.org/10.1007/978-0-387-78851-7_22

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