Spontaneous Stoma Closure: A Case Report and Review of the Literature.

ABSTRACT

Stomas serve various purposes, and surgical closure of temporary stomas is typically performed once the underlying reason for their creation has been resolved. However, spontaneous closure of a stoma without surgical intervention is exceptionally rare. Here, we present a case of spontaneous stoma closure. A 67-year-old female presented with symptoms indicative of partial bowel obstruction. A computed tomography (CT) scan revealed circumferential wall thickening involving the transverse, splenic flexure, and proximal descending colon, along with a dilated proximal colon. Urgent intervention led to a total colectomy with ileorectal anastomosis and the creation of a diverting loop ileostomy. Six months later, she was then booked for stoma closure but found that the stoma was already closed, and the patient reported a history of pushing the stoma inside by herself. Spontaneous closure of a stoma is extremely rare. The mechanism behind spontaneous closure is not fully understood. Stoma retraction or the healing process of an enterocutaneous (EC) fistula can be attributable factors. Only six cases of spontaneous stoma closure have been reported in the literature. The technique that has been described by the patient of pushing the stoma inside has not been discussed before. Gradual retraction of the stoma and the healing process of EC fistula are the most common acceptable factors. The technique of pushing the stoma inside could be a helpful factor in spontaneous stoma closure. Long-term follow-up can help in understanding the unclear mechanism of this condition.