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Revista Española de Sanidad Penitenciaria

versión On-line ISSN 2013-6463versión impresa ISSN 1575-0620

Rev. esp. sanid. penit. vol.22 no.1 Barcelona ene./abr. 2020  Epub 11-Mayo-2020

https://dx.doi.org/10.18176/resp.0008 

Visual Image of Prison Health Care

Ostomy prolapse

Prolapso de estoma

C Juan-Juan1  , P Saiz de la Hoya-Zamácola1 

1Servicios Médicos. Centro Penitenciario de Fontcalent. Alicante.

CLINICAL DESCRIPTION

48 year old male with social difficulties, admitted into prison.

Refers that he has been operated on for cancer of the colon nine months ago, and since then has not attended any medical check by specialists (oncology or surgery). The patient is homeless although he does receive some family support.

Drug user and undergoing replacement therapy with methadone. Was an intravenous drug user (IDU). There are no other personal details of interest.

Presented a stoma prolapse of more than 15 cm length and over 25 cm perimeter (Figures 1 and 2) at the base. No signs of infectious process or progression of the cancer, apart from caquexia.

Figure 1. Ostomy prolapse 1 

Figure 2. Ostomy prolapse 2 

EVOLUTION

Cross-consultation was requested with surgery, and an intervention via local approach was carried out, the stoma was freed from the abdominal wall, the redundant intestine was removed and the stoma was reshaped (Figures 3 and 4).

Figure 3. Operated prolapse 

Figure 4. Ostomy with post-op bag 

The studies showed that there was a progression of the cancer with liver metastasis. The patient was released after applying article 196 of the Prison Regulations.

He entered prison in a generally bad state and underweight, with a body mass index (BMI) of 18.

COMMENTS

A prolapse is a late complication of colostomíes, and is defined as the protrusion of the stoma above the abdominal surface. It is a rare complication (2-10%), the frequency of which varies according to the location of the stoma, and if more common in ileostomies and loop colostomies, and less in terminal colostomies.

The origins of a prolapse are unclear and depend on a lot of factors. Possible causes include constipation, mismatch between the size of the intestine and the hole made in the abdominal wall and the existence of long, mobile intestinal loops.

Recurrence is frequent.

Received: October 15, 2019; Accepted: October 24, 2019

Correspondence: Cristina Juan Juan. E-mail: 0611lago@gmail.com.

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License