Chronic Functional Intussusception into a Prolapsed Loop Colostomy

Special Article - Surgical Case Reports

Austin J Surg. 2015;2(4): 1064.

Chronic Functional Intussusception into a Prolapsed Loop Colostomy

Dan D*, Bascombe N and Naraynsingh V

Department of Clinical Surgical Sciences, University of the West Indies, Jamaica

*Corresponding author: Dan D, Department of Clinical Surgical Sciences, University of the West Indies,26 London Street, St. Joseph Village, San Fernando,Jamaica

Received: May 18, 2015; Accepted: June 18, 2015; Published: June 25, 2015


A 38-year-old man underwent multiple surgical procedures for fecal peritonitis, the last of which involved the fashioning of a diverting loop colostomy. Five years later the patient presented with a massive prolapsing colostomy (retrograde and ante-grade). This was functional for 5 years before he considered surgery. He managed well in terms of bowel function but found difficulty handling the ostomy with homemade ostomy plastic bags. Due to distal colonic atrophy a total colectomy with end ileostomy was performed. The patient’s post-op recovery was uneventful and up to 1 year later he had no complaints and the ileostomy was functioning well.

A review of the literature reveals the rarity of this colostomy complication, and its management has been based on the individual situation. When presented with a prolapsing enterostomy that cannot be reduced, the diagnosis of intussusception in the ostomy should be entertained. Reversal of diverting stomas should be done in a timely manner to avoid this and other complications.

Keywords: Prolapse; Intussusception; Colostomy; Enterostomy


Multistage procedures as surgical therapy are sometimes necessary when dealing with certain colonic emergencies or elective colonic procedures. Creating a diverting colostomy may play a very important role in these cases; however, this can be associated with various complications, prolapse being the most common [1].

Intussusception in a colostomy is very rare and there are very few reported cases in the literature [2]. We present the case of an adult male who was treated for fecal peritonitis resulting in the creation of a right-sided loop colostomy. The patient developed multiple intussusceptions in the colostomy (ante-grade and retrograde). To our knowledge, this is the first case of multiple intussusceptions in a loop colostomy in the published literature.

Case Report

A 38-year-old man suffered gunshot wound to the abdomen 13 years ago. The internal injury was confined to the sigmoid colon, which was repaired primarily. Three years later the patient presented with an acute abdomen secondary to sigmoid diverticular perforation. The perforated segment of the sigmoid colon was removed and primary anastomosis performed. Subsequently, the patient developed colovesical and colocutaneous fistulae. This was treated by diversion of the stool by way of a loop colostomy at the mid ascending colon. Five years later he noticed the colostomy getting larger but never sought assistance until another 5 years. By this time the bowel at the colostomy site was protruding to the other side of his abdomen (Figure 1), with no adverse effect on the intestinal function. Due to the massive size of the prolapsed segment, he used a homemade plastic bag to collect stool, which would often lead to leakage and odor that was more disturbing to the family members.