Which of the following is an etiology of stomal prolapse?

• A. Ongoing obstruction
• B. Pregnancy
• C. Large abdominal wall opening
• D. Increased abdominal pressure due to coughing

Answer: (A)

Stomal prolapse happens when a loop of bowel telescopes through the stoma. Ongoing obstruction drives this process because it causes upstream bowel to become distended and more mobile, increasing the likelihood that a longer segment will slip out through the stoma and stay protruding. The persistent intraluminal pressure and distention provide the direct mechanical trigger for prolapse. Other factors like a large abdominal wall opening, pregnancy, or coughing can raise intra-abdominal pressure or permit more bowel to move, but they’re less direct causes; obstruction supplies the primary mechanism that makes prolapse more likely. In management, addressing the obstruction and supporting the stoma to prevent further protrusion are key steps.