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Parastomal hernia

Robert R Cima, MD, MA, FACS, FASCRS
Section Editor
Michael Rosen, MD
Deputy Editor
Wenliang Chen, MD, PhD


Parastomal hernia is the most frequent complication following the construction of a colostomy or an ileostomy, occurring in up to 50 percent of patients. A parastomal hernia is a type of incisional hernia that allows protrusion of abdominal contents through the abdominal wall defect created during ostomy formation (image 1). It should be recognized that, unlike a hernia development in a surgical incision for which the fundamental problem is healing between tissues that have been approximated, ostomy creation introduces an abdominal wall defect, the trephine, for which no healing is expected. A parastomal hernia forms as the trephine is continually stretched by the forces tangential to its circumference [1].  

The construction of an ostomy and the management of patients with an ileostomy or colostomy are reviewed separately. (See "Overview of surgical ostomy for fecal diversion" and "Routine care of patients with an ileostomy or colostomy and management of ostomy complications".)


The reported incidence of parastomal hernia varies widely and is related the type of ostomy constructed, the duration of follow-up after ostomy construction, and the definition used to identify parastomal hernia. The incidence of parastomal hernia is reported as ranging from 0 to 50 percent, depending upon the type of ostomy [2-12]. One review found the following rates of parastomal hernia formation [12]:

End-ileostomy – 1.8 to 28.3 percent

End-colostomy – 4.0 to 48.1 percent

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Literature review current through: Nov 2017. | This topic last updated: Feb 08, 2017.
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