¹Lindsay Vejarano-Lezama, ²Lisbeth Huillca-Núñez, ³Carlos Velasquez-Hawkins, ⁴Giancarlo Francois Castillo

¹Servicio de Cirugía General, Hospital Luis Negreiros Vega, Seguro Social de Salud, Lima, Peru Address: Av. Tomás Valle cuadra 39, Callao, Peru Postal Code: 07036

Clínica Sanna San Borja, Lima, Peru Address: Av. Guardia Civil 337, San Borja, Peru Postal code: 15036 ORCID: 0009-0007-9597-720X; Mail: dravejarano@gmail.com

²Clínica Sanna San Borja, Lima, Peru Address: Av. Guardia Civil 337, San Borja, Peru Postal code: 15036 ORCID: 0009-0009-8253-8755; Mail: lishuillca@gmail.com

³Clínica Sanna San Borja, Lima, Peru Address: Av. Guardia Civil 337, San Borja, Peru Postal code: 15036 ORCID: 0000-0002-9217-9559; Mail: cirugia306@gmail.com

⁴Servicio de Cirugía General, Hospital Luis Negreiros Vega, Seguro Social de Salud, Lima, Peru Address: Av. Tomás Valle cuadra 39, Callao, Peru Postal code: 07036; ORCID: 0000-0002-5942-5543; Mail: giancarlocastillot@gmail.com

Corresponding author: Lindsay Vejarano-Lezama, Servicio de Cirugía General, Hospital Luis Negreiros Vega, Seguro Social de Salud, Lima, Peru, Address: Av. Tomás Valle cuadra 39, Callao, Peru Postal code: 07036, Clínica Sanna San Borja, Lima, Peru Address: Av. Guardia Civil 337, San Borja, Peru Postal code: 15036  ORCID: 0009-0007-9597-720X;  Mail: dravejarano@gmail.com

Citation: Lindsay Vejarano-Lezama, Lisbeth Huillca-Núñez, Carlos Velasquez-Hawkins, Giancarlo Francois Castillo, (2026). Type IV Parastomal Hernia Repair and Simultaneous Colostomy Closure. Case Report. American J Case Rep Clin Imag. 2026; Feb, 4(1), 1-3.

Copyrights © 2026, Lindsay Vejarano-Lezama, et al, This article is licensed under the Creative Commons Attribution-Non-Commercial-4.0-International-License-(CCBY-NC) (https://amejcaserepclinimag.com/blogpage/copyright-policy). Usage and distribution for commercial purposes require written permission.

Abstract

Objective: To describe the repair of a complex parastomal hernia and simultaneous ileostomy closure using abdominal wall prehabilitation. Case report: A 53-year-old male patient with an ileostomy developed a parastomal hernia and a midline incisional hernia following a previous laparotomy. Abdominal wall prehabilitation was performed with botulinum toxin administration and abbreviated pneumoperitoneum. Subsequently, abdominal wall reconstruction and restoration of intestinal transit were performed in a single procedure. Results: The surgery was performed without complications. The patient presented good clinical evolution in the immediate postoperative period and at follow-up. Discussion: The treatment of complex abdominal hernias requiring restoration of intestinal transit represents a challenge. Prehabilitation with botulinum toxin and the use of pneumoperitoneum are useful tools to optimize abdominal closure and facilitate reconstructive surgery. The decision to use combined management should be individualized and carried out by a specialized team to ensure the best results.

Keywords: Botulinum toxins, Type A, Ileostomy, Pneumoperitoneum, Surgical puanastomosis, Ventral hernia.