A 55-year-old woman with rectal cancer undergoes abdominoperineal resection with permanent end colostomy. Two weeks post-operatively, the stoma appears dusky, ischaemic, and retracted below the fascial level. What is the most likely cause?
- A Stoma prolapse
- B Stoma ischaemia/necrosis due to inadequate vascular supply ✓
- C Parastomal hernia
- D Mucocutaneous separation
Correct answer: B. Stoma ischaemia/necrosis due to inadequate vascular supply
Explanation
Stoma ischaemia/necrosis presents within 24-48 hours (or up to a week) with dusky or black discolouration and retraction. It results from excessive mesenteric tension, ligation of the inferior mesenteric artery, or inadequate mobilization. Prolapse presents later with lengthening. Parastomal hernia causes a bulge. Mucocutaneous separation is a wound complication at the suture line.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.