Uncommon gastric hernia in a parastomal defect.

An 84-year-old woman with a Barthel Index of 40 and a history of rectal adenocarcinoma treated with total mesorectal excision and colostomy presented with a 24-hour history of abdominal pain, vomiting, and a defunctioning ileostomy. Examination revealed hemodynamic instability, a distended abdomen, and diffuse tenderness around the parastomal hernia. CT scan revealed significant gastric dilation extending through the parastomal hernia with obstructive changes at the gastroduodenal junction. Parastomal hernias are relatively common, with an incidence of 0-48.1%.