Differential Diagnosis for Beefy Red, Tender Stoma

• Single Most Likely Diagnosis
  • Stomal ischemia or necrosis: This condition is a common complication following stoma creation, especially if the blood supply to the stoma is compromised. The beefy red appearance can be due to inflammation, and tenderness is a hallmark of ischemia.
• Other Likely Diagnoses
  • Stomal prolapse: Although prolapse might not directly cause a beefy red appearance, the associated inflammation and potential for compromised blood flow could contribute to these symptoms.
  • Stomal stenosis: Inflammation and scarring leading to stenosis could cause pain and tenderness, but the beefy red appearance might be less typical unless there's an associated infection.
  • Infection (e.g., cellulitis, abscess): Infections around the stoma can cause redness, tenderness, and swelling, fitting the description provided.
• Do Not Miss Diagnoses
  • Necrotizing fasciitis: Although rare, this condition is life-threatening and can present with severe pain, redness, and swelling. The "beefy red" description could be consistent with the early stages of necrotizing fasciitis.
  • Sepsis (secondary to stomal complications): Any condition leading to sepsis is critical and must be considered, especially if the patient shows signs of systemic infection (fever, tachycardia, hypotension).
• Rare Diagnoses
  • Pyoderma gangrenosum: A rare skin condition that can cause painful ulcers and might present around a stoma, though it's less common.
  • Crohn's disease or ulcerative colitis recurrence: In patients with a history of inflammatory bowel disease, recurrence around the stoma can cause inflammation and complications, though the "beefy red" description might not be the most typical presentation.