Nothing prepared us for Mr M

Mrs Rachel Pasley1, Mrs Lorraine Andrews2
1Northland District health Board, Whangarei, New Zealand, 2Omnigon, Epsom, New Zealand

A significant portion of Rachel’s client base are from a lower soci-economic group having high health care needs with limited resources and low heath literacy skills. Rachel remains passionately committed to delivering a high quality service utilizing outstanding advocacy skills.

Accounting for 8% of ostomy skin issues granuloma lesion are a relatively common finding in stomal therapy practice.  While not always problematic , once established if not treated the commonest pathway is for them to enlarge until they cause pouching issues, skin damage and bleeding.  Remarkably ostomates will often tolerate hypergranuloma lesions without reporting them until bleeding becomes an issue.

This poster will present the care we provided to Mr M, who presented once he was desperate and experiencing significant bleeding from what were initially un-identified lesions.

Nothing prepared us for the issue Mr M revealed when he removed his appliance.


Rachel is a community STN practicing in the culturally diverse region of  Northland.  She delivers stoma care to over 400 clients spread over a wide geographical area.  Rachel initially registered as an Enrolled Nurse in 1989 before completing her Registered Nurse program in 1994.  She completed the Post Graduate Certificate of Stomal Therapy Nursing in 2008.