Stenosis may occur at which anatomical layers?

• A. Skin layer only
• B. Skin layer or fascia muscular layer
• C. Fascia muscular layer only
• D. Subcutaneous tissue

Answer: (B)

Stenosis of a stoma can happen at the points where the stoma tract presses through the abdominal wall—the skin layer and the deeper fascia–muscular layer. If the opening at the skin becomes tightened by swelling, scarring, or tissue contraction, the stoma lumen narrows there. Likewise, scar tissue or a tight fascial edge around the stoma as it traverses the fascia-muscular plane can pinch the lumen deeper down. Because narrowing can occur at either of these tissue interfaces, stenosis may be seen at the skin layer or the fascia muscular layer. Subcutaneous tissue alone isn’t typically the site of luminal narrowing, and stating it occurs only in the fascia-muscular layer would miss cases that happen at the skin level.