Qamar A Ahmad, Kamran Saeed, Mah Jabeen Muneera, Rfraz Ahmed M Sarfraz, Kamran Khalid.
Indications and complications of intestinal stomas – a tertiary care hospital experience.
Biomedica Jan ;26(2):144-7.
Introduction: An intestinal stoma is an opening of intestine on the anterior abdominal wall made surgi-cally. The commonly performed procedures include colostomy and ileostomy. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. Subjects and Method: An observational study was carried out in Services Hospital Lahore, over a period of two years from Feb. 2007 – 09. A total of 85 patients needing intestinal stomas, ileostomy or colostomy, were included in the study. Patients under 12 years, with enterocutaneous fistula and urinary conduits were excluded from study. Indications, immediate and late complications of stomas were recorded. Reversal of stoma usually performed after 12 weeks and complications of reversal were also recorded. Results: Majority (73%) of patients were males. There were 36 ileostomies and 49 cases of colostomy mak-ing a total of 85 patients. Main indications of Ileostomy were intestinal tuberculosis (58%), enteric perforation (31%) and penetrating injuries (5.5%). Colostomy was mostly required in penetrating injuries (33%), blunt trauma (23%) and intestinal obstruction (28%). In a total of 35 stomas local complications appeared in 54 (41.77%). General problems included anxiety, psychological and social isolation. Skin exco-riation and ulceration were the most common (25%); they were worse in ileostomy than colostomy. In laparotomy wound infection (9.4%), stoma diarrhea (7%), stoma retraction (6%) and prolapse (6%) were other notable comp-lications. A mortality rate of 1.6% was found in cases of ileostomy. Hospital admission ranged from 10 – 62 days. 62 stomas including 25 ileostomies and 37 colostomies were closed on an ave-rage of 3 months after primary operation. There were 9 cases of wound infection, three anastamotic leak-ages and a single mortality (1.6%) in the stoma reversal group. Conclusion: Common indications for intestinal stomas were abdominal trauma, intestinal tuberculosis and enteric perforation. Main complications included local skin problems, stoma diarhoea, prolapse and retraction. Early identification and treatment of tuberculosis and enteric fever can reduce stoma forma-tion and its associated complications.
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