Management of a growing Desmoid tumour in the setting of familial adenomatous polyposis with an existing ileostomy and active fistula in a nursing home setting

Mrs Rebecca Hook1, Ms Kirralee Foster
1University Hospital Geelong, Geelong West, Australia

We will follow the journey of 49 year old Mrs K who has a history of Familial adenomatous Polyposis.  This condition has subsequently resulted in a rapidly changing desmoid tumour.

The tumour was intially internal and has since become external.

She has an existing ileostomy and faecal fistula resulting in issues with the management of faecal output from both the fistula and the ileostomy. She resides in a nursing home and relies on nursing staff for all pouch changes and on going care.

Management was initially achieved with the use of small coloplast wound pouches but as the tumour grew and changed over the following 18 months, the use of various sized Eakin wound pouches were required to achieve some degree of tumour, fistula and stoma management due to the close proximity of all of the above. The tumour size has varied from 8cm x 8 cm to 36cm x 34cm.

Palliative care are involved with ongoing care, however with an unknown disease progression, and the nature of the ever changing tumour size,  stomal therapy involvement continues to be intermittent but ongoing.


Biography:

Rebecca has been a qualified Stomal therapy Nurse for 10 years and has a background in colorectal nursing. She works 3 days a week in the Stomal Therapy department at University Hospital Geelong. Kirralee is a recently qualified Stomal therapy nurse and is the third member of the stomal therapy team in Geelong.  They look after over 120 new stomas per year.