Chronic Functional Intussusception into a Prolapsed Loop Colostomy

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.