PMC7327875_01
Skin redness and erosion formation.
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The intestinal fluid extensively stimulated the skin, causing redness and the formation of erosions and resulting in a refractory ECF with spontaneous pain (Fig. 1).
Skin irregularities appear due to granulation.
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Although increasing the negative pressure from -30 to -50 cmH2O decreased the leakage and temporarily improved the skin erosion and granulation, further skin depression appeared due to the formation of granulation, enabling the pouch to adhere to the skin and worsening the skin symptoms (Fig. 2).
Fluoroscopy.
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Two months after construction of the ileostomy, percutaneous intestinal puncture was performed under fluoroscopy, and contrast medium was injected to confirm the running of the oral intestinal tract (Fig. 3).
a, b: After percutaneous intestinal drainage.
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The incised intestinal wall, peritoneal fascia and the skin were closed with sutures, and then the operation was completed (Fig. 4a, b).
a, b: Erosion improvement and suture closure.
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This treatment clearly reduced discharged fluid and both the skin redness and erosion gradually improved (Fig. 5a). Both the opened intestinal wall and skin were closed (Fig. 5b).
After removing the drainage catheter.
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No subsequent problems were noted in the abdominal findings (Fig. 6).