PMC9550486_01
Computed tomography scan of gallbladder fundus herniation into parastomal hernia (arrow) with thickened fundal wall and pericholecystic fluid in axial plane.
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C-reactive protein 14 mg/L, lipase 1349 U/L, bilirubin 9 umol/L, and deranged liver enzymes. Computed tomography (CT) demonstrated a parastomal hernia containing a portion of nonobstructed transverse colon and the gallbladder with a thickened fundus, pericholecystic fluid, and impacted stone (Figure 1).
Computed tomography scan of gallbladder herniation (arrow) and large complex cystic head of pancreas lesion (star) in coronal plane.
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The known pancreatic head lesion was stable in size (Figure 2).
Right-sided parastomal hernia of urostomy site with surrounding bile staining skin which developed within 12 hours of presentation raising concern of gallbladder perforation.
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On review that afternoon, her pain worsened and new bile staining surrounding the urostomy site was noted (Figure 3).
Right-sided parastomal hernia 2-month after discharge. Bile staining skin changes completely resolved. Superior peristomal skin ulceration.
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The skin changes secondary to bile staining completely resolved (Figure 4).