Which statement best describes signs suggesting ischemia in peristomal hernia assessment?

• A. Signs of ischemic bowel
• B. Pain presence
• C. Change in wear time
• D. New leakage

Answer: (A)

Ischemia in a peristomal hernia means the bowel segment inside the hernia is not getting enough blood supply, risking tissue death. The clearest clue during assessment is signs that the bowel itself is ischemic: a change in color of the protruding bowel or stoma to pale, mottled, purple, or black, often accompanied by sudden or severe, progressive pain and tenderness. These findings point to compromised viability and require urgent evaluation. Pain alone can be nonspecific, and changes in wear time or new leakage are usually related to appliance issues rather than blood flow to the bowel.