Lateral Approach Circumstomal Open Retrorectus Mesh Repair with Transversus Abdominis Release and Three-Point Stomal Pexy for an Acute-on-Chronic Complex Parastomal Hernia Causing High-Grade Gastric Outlet Obstruction: A Case Report

Acute parastomal hernia containing the stomach with subsequent mechanical gastric outlet obstruction is an exceedingly rare phenomenon given the anatomical fixation of the stomach. Herein, we present the case of an 81-year-old female with a history of a Hartmann’s procedure who developed acute vomiting. She was found to have herniation of the stomach into the parastomal hernia sac with tight angulation of the gastroduodenal junction and, therefore, gastric outlet obstruction. Following decompression with a nasogastric tube, we report an open approach with circumstomal mesh for acute emergent repair.