Table 6 Classification systems of PSH
From: Surgical management of ostomy complications: a MISSTO–WSES mapping review
System | Types | Description |
|---|---|---|
EHS (radiological and intraoperative) | Type I | PSH defect area ≤ 5 cm without concomitant incisional hernia |
Type II | PSH defect area ≤ 5 cm with concomitant incisional hernia | |
Type III | PSH defect area > 5 cm without concomitant incisional hernia | |
Type IV | PSH defect area > 5 cm with concomitant incisional hernia | |
Moreno-Matias (radiological) | Type 0 | Normal, peritoneum follows the wall of the bowel forming the stoma with no formation of a sac |
Type Ia | Bowel forming the colostomy with a sac < 5 cm | |
Type Ib | Bowel forming the colostomy with a sac > 5 cm | |
Type II | Sac containing omentum | |
Type III | Intestinal loop other than the bowel forming the stoma | |
Devlin (intraoperative) | Type I | Interstitial hernia |
Type II | Subcutaneous hernia | |
Type III | Intrastomal hernia | |
Type IV | Peristomal hernia (stoma prolapse) | |
Rubin (intraoperative) | Type Ia | True parastomal interstitial hernia |
Type Ib | True parastomal subcutaneous hernia | |
Type II | Intrastomal hernia | |
Type III | Subcutaneous prolapse | |
Type IV | Pseudohernia (connected with flank insufficiency or denervation) | |
Gil and Szcepkowski (clinical) | Type I | Isolated small parastomal hernia |
Type II | Small parastomal hernia with coexisting midline incisional hernia | |
Type III | Isolated large parastomal hernia | |
Type IV | Large parastomal hernia with coexisting midline incisional hernia |