scholarly journals A study of complications of temporary ileostomy in cases of acute abdomen with ileal perforation and obstruction

2018 ◽  
Vol 5 (10) ◽  
pp. 3265
Author(s):  
Chandan Roy Choudhury ◽  
Tshering Doma Bhutia ◽  
Bodhisattva Bose
Keyword(s):  
Loop Ileostomy ◽  
Emergency Setting ◽  
Prospective Data ◽  
Temporary Ileostomy ◽  
Biopsy Report ◽  
Enteric Perforation ◽  
Closure Of Ileostomy ◽  
Peristomal Complications ◽  
User Friendly ◽  
Background Construction

Background: Construction of a gastrointestinal stoma is a frequently performed surgical procedure. Although formation of defunctioning loop ileostomy is usually a straightforward procedure, there is an appreciable complication rate. The purpose of the research was to study the complications, outcome associated with temporary ileostomy and to study the complications related to its closure.Methods: Institutional based observational study using prospective data collection large ileal perforations covering more than one third of the circumference, or gangrenous change or severe adhesions and old perforations with presence of peritoneal contamination were included in the study. 50 patients were included in the study. Clinical, intra-operative, biochemical parameters with stomal and peristomal complications and tissue histopathology were assessed in the study.Results: The commonest aetiology for which stoma was performed enteric perforation (44%) whereas perforation was the commonest aetiology for which stoma was performed (64%) apart from gangrene and other aetiologies. The commonest post-operative complication encountered was skin excoriation (64%). Most of the the complications encountered post operatively were statistically significant when correlated with aetiology and duration of presentation.Conclusions: Although being bothersome, loop ileostomy is still a live saving procedure. Complications of stoma could be managed conservatively with the application of proper user-friendly stoma appliances and it is of paramount importance that ileostomies are properly sited. Before closure of ileostomy it is essential to be careful of operative biopsy report showing non-specific inflammation. Preference of surgeons in the present day to perform ileostomy in emergency setting is increasing.

The impact of timing of stoma closure on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer

2021 ◽  
pp. 126-134
Author(s):  
Hemn Hussain Kaka Ali ◽  
Qalandar Hussein Abdulkarim ◽  
Karzan Seerwan ◽  
Barham M. M .Salih
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Anal Verge ◽  
Loop Ileostomy ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Closure Of Ileostomy ◽  
The Mean ◽  
The Impact

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.    

scholarly journals A study of surgical approach to typhoid ileal perforation at a tertiary care hospital of South Gujarat, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1758
Author(s):  
Archana A. Nema ◽  
Jitendra R. Darshan
Keyword(s):  
Primary Closure ◽  
Loop Ileostomy ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
High Rate ◽  
Care Hospital ◽  
Ileal Perforation ◽  
Mortality And Morbidity ◽  
Clinical Presentations ◽  
Enteric Perforation

Background: Even with variety of procedures, typhoid (enteric) perforation still has a high rate of morbidity and mortality. The aim of the present study is to study clinical presentations, to evaluate management pattern of typhoid ileal perforation, to determine mortality and morbidity of perforation and to study the re-exploration rate and causes of re-exploration and its effect on mortality and morbidityMethods: This prospective observational study was conducted in the Departments of Surgery at Surat Municipal Institute of Medical Education and Research, Surat during June 2008 till October 2010. A total 45 patients with typhoid ileal perforation were included in the study. Among them, 32 cases (71%) undergone the simple primary closure of the perforation and peritoneal lavage after refreshing the edge, 7 cases (16%) undergone exploratory laparotomy with proximal loop ileostomy with primary closure and 6 (13%) were operated by exploratory laparotomy with resection anastomosis.Results: Mean duration of the stay for patient undergone PC+PL was 10.20 days and for ileostomy it was 18.4 days and for RA + PL it was 18.6 days. Total 37 incidence of complications were found in 45 cases. Among them wound infection was presented in 16 (43%) and burst abdomen presented in 2 (5%) cases. Fecal fistulae, post-operative collection and pneumonitis were present in 4 (11%) cases each.Conclusion: The overall mortality was found nearly 4 percent in our study. The typhoid ileal perforation should be always treated surgically. There are many operative techniques to deal with, but no one is full proof.

scholarly journals Liver Resections Combined with Closure of Loop Ileostomies: A Retrospective Analysis

HPB Surgery ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Jeffrey T. Lordan ◽  
Angela T. Riga ◽  
Nariman D. Karanjia
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Hospital Stay ◽  
Colorectal Liver Metastases ◽  
Loop Ileostomy ◽  
Ileostomy Closure ◽  
Perioperative Morbidity ◽  
Liver Resections ◽  
Closure Of Ileostomy ◽  
Prolonged Hospital

Background. The management of patients with colorectal liver metastases and loop ileostomies remains controversial. This study was performed to assess the outcome of combined liver resection and loop ileostomy closure. Methods. Analysis of prospectively collected perioperative data, including morbidity and mortality, of 283 consecutive hepatectomies for colorectal liver metastases was undertaken. Consecutive liver resections were performed from 1996 to 2006 in one centre by a single surgeon (NDK). Fourteen of these patients had combined liver resection and ileostomy closure. Case-matched analysis was undertaken. Results. Six (2.2%) patients died in the hepatectomy only group and none died in the combined group. There was no difference in operative blood loss between the two groups (0.09). Perioperative morbidity was 36% in the combined group and 23% in the hepatectomy alone group (P=0.33). Mean hospital stay was 14 days in the combined group and 11 days in the hepatectomy only group (P=0.046). Case-matched analysis showed a significant increase in hospital stay (P=0.03) and complications (P=0.049) in the combined group. Conclusion. In patients with CRLM, combined liver resection and closure of ileostomy may be associated with a higher operative morbidity and a prolonged hospital stay.

scholarly journals Study of intestinal stoma: our experience at Rajarajeswari Medical College and Hospital

2019 ◽  
Vol 6 (10) ◽  
pp. 3622
Author(s):  
Veena A. ◽  
Hariprasad T. R. ◽  
Gopal S.
Keyword(s):  
Loop Ileostomy ◽  
Medical College ◽  
Stoma Formation ◽  
Artificial Opening ◽  
End Colostomy ◽  
Enteric Perforation ◽  
Intestinal Stoma ◽  
Perianal Sepsis ◽  
Carcinoma Colon ◽  
Operative Findings

Background: Stoma is an artificial opening of intestinal or urinary tract to the abdominal wall. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it.Methods: This is a retrospective descriptive observational study carried out in a surgical unit of Rajarajeswari Medical College and Hospital, Bangalore from August 2015 to August 2016. Data was collected by previous record files including age, gender, history of presenting illness, indication, type of stoma, type of surgery, appropriate operative findings and follow up of the cases. The results were collected, analysed and compared with other studies.Results: A total of 25 patients were evaluated age ranged between 20-70 years. Out of 25 patients 17 were admitted in emergency while 8 in out-patient department. The most common type of stoma made was loop ileostomy (44%) followed by end ileostomy (28%), end colostomy (16%) and loop colostomy (12%). Main indication for a stoma formation was enteric perforation (56%) followed by carcinoma colon and rectum (32%), perianal sepsis (21%), Koch’s abdomen (11%), penetrating injuries (11%). Of the various complications encountered with intestinal stoma, peristomal skin Excoriation (16%) was the most common complication observed followed by other complications as mentioned in study.Conclusions: In spite of enormous exposure of general surgeons towards stoma formation the complications are inevitable. Early detection of complication and its timely management is the keystone.

scholarly journals A STUDY OF SURGICALAPPROACH TO TYPHOID ILEAL PERFORATION

2020 ◽  
pp. 1-3
Author(s):  
Sitesh Kumar Karn ◽  
Ramesh Kumar Ajai ◽  
Debarshi Jana
Keyword(s):  
Primary Closure ◽  
Loop Ileostomy ◽  
Exploratory Laparotomy ◽  
High Rate ◽  
Ileal Perforation ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Clinical Presentations ◽  
Enteric Perforation ◽  
Full Proof

Introduction: Even with variety of procedures, typhoid (enteric) perforation still has a high rate of morbidity and mortality. The aim ofthe present study is to study clinical presentations, to evaluate management pattern of typhoid ileal perforation, to determine mortality and morbidity of perforation and to study the re-exploration rate and causes of re-exploration and its effect on mortality and morbidity. Methods: This prospective observational study was conducted in the Department of Surgery at Nalanda Medical College and Hospital, Patna, Bihar during May 2019toApril 2020. A total 45 patients with typhoid ileal perforation were included in the study. Among them, 32 cases (71%) undergone the simple primary closure of the perforation and peritoneal lavage after refreshing the edge, 7 cases (16%) undergone exploratory laparotomy with proximal loop ileostomy with primary closure and 6 (13%) were operated by exploratory laparotomy with resection anastomosis. Results: Mean duration of the stay for patient undergone PC+PL was 10.20 days and for ileostomy it was 18.4 days and for RA + PL it was18.6 days. Total 37 incidences of complications were found in 45 cases. Among them wound infection was presented in 16 (43%) and burst abdomen presented in 2 (5%) cases. Fecal fistulae, post-operative collection and pneumonitis were present in 4 (11%) cases each. Conclusion: The overall mortality was found nearly 4 percent in our study. The typhoid ileal perforation should be always treatedsurgically. There are many operative techniques to deal with but no one is full proof.

scholarly journals LOOP ILEOSTOMY

2011 ◽  
Vol 18 (02) ◽  
pp. 222-227
Author(s):  
MUHAMMAD SHER-UZ-ZAMAN ◽  
FAWAD HAMEED ◽  
SHEIKH ATIQ-UR-REHMAN ◽  
Younis Khan
Keyword(s):  
Typhoid Fever ◽  
Psychological Symptoms ◽  
Loop Ileostomy ◽  
Case Series ◽  
Female Ratio ◽  
Life Saving ◽  
Surgical Units ◽  
Case Series Study ◽  
Enteric Perforation ◽  
Considerable Morbidity

Enteric perforation is a disastrous complication of untreated or poorly treated typhoid fever and unless treated by surgical method, it results in considerable morbidity and mortality. The purpose of this study to describe complications of ileostomy in patients of enteric perforation. Place & Duration of study: The study was conducted was in surgical units B-V hospital, Bahawalpur from 1st July 2008 to 30th June 2009. Material & Method: This was a descriptive case series study. 100 patients of both genders suffering from typhoid fever with perforation who underwent ileostomy were included the study. All the data was collected on pre-designed proforma. Results: Most of the patients were young with male to female ratio 1.6:1. Ileostomy was done in all the patients after cleaning the peritoneal cavity. Ileostomy was associated with diarrhea 20%, peristomal skin problems 22%. Other complications were bleeding in 3%,prolapsed in 5%, retraction in 4%, parastomal hernia in 5%, wound infection in 8%, intestinal obstruction in 5% patients, incisional hernia & psychological symptoms in 2% patients and stoma stenosis in one patient in our study. Two patients expired due the complication of ileostomy. Conclusions: Although ileostomy is not the most favored way of treatment of enteric perforation and it is associated with a number of complications and management problems, it is still a good option and life saving procedure in our setup where patients present very late with gross peritoneal contamination. 

scholarly journals Incidence and management of intestinal perforation in typhoid: a prospective, observational study

2020 ◽  
Vol 7 (5) ◽  
pp. 1570
Author(s):  
Bhanwar L. Yadav ◽  
Somendra Bansal ◽  
Shalu Gupta ◽  
Pradeep K. Verma
Keyword(s):  
Observational Study ◽  
Intestinal Perforation ◽  
Prospective Observational Study ◽  
Primary Repair ◽  
Bowel Perforation ◽  
Loop Ileostomy ◽  
Mortality Data ◽  
Time Interval ◽  
Female Ratio ◽  
Enteric Perforation

Background: Intestinal perforation is a common surgical problem, which need proper attention. Typhoid is the most common cause of bowel perforation. With the concept of a correct diagnosis of perforation in reference to its etiology and further study of etiological factor (typhoid) in relation to epidemiology, surgical treatment and outcome, the present study has been undertaken.Methods: It is a prospective, observational study in which 50 cases of enteric perforation admitting in SMS Hospital at JAIPUR were observed. All patients of enteric perforation peritonitis were evaluated by detailed history, clinical examination and radiological as well as laboratory investigations. After initial resuscitation patient were treated by operative procedures. Postoperatively progress report, morbidity and mortality data were observed.Results: Mean age of patients was 26.38 years. Male to female ratio was 4:1. Enteric perforation is more common in patients with poor nutritional status and rural area. Primary repair of perforation was done in patient with small perforation with relatively healthy bowel, while ileostomy was done in patients with large perforation of longer duration, multiple perforations and edematous bowel with necrotic patches. Mortality was highest in patients who underwent primary repair and proximal loop ileostomy (33.3%) and lowest in patients in which exteriorization of the perforation as loop ileostomy was done (10.3%).Conclusions: The time interval between occurrence of perforation and starting of specific therapy is the most important factor in deciding the ultimate outcome of the typhoid perforation patient and operative procedure is another important factor in deciding the outcome.

scholarly journals Intestinal stomas: A clinical study in a Teaching Hospital, our experience

2020 ◽  
Vol 9 (1) ◽  
pp. 37-42
Author(s):  
Om Bahadur Karki
Keyword(s):  
Intestinal Obstruction ◽  
Wound Infection ◽  
Teaching Hospital ◽  
Loop Ileostomy ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Local Skin ◽  
Stoma Formation ◽  
Enteric Perforation

Background: An intestinal stoma is an opening of the intestine on anterior abdominal wall made with an intention of either decompression of an obstructed colon or diversion of stool. Intestinal stomas may be temporary or permanent, depending on their role.   Objectives: The objective of this study was to determine the common indications and types of intestinal stomas, and outcomes of patients operated at Manipal Teaching Hospital, Pokhara, Nepal. Methodology:  A retrospective cross-sectional study was conducted in 105 patients of intestinal stomas from February 2017 to March   2020 in a teaching hospital after approval from institutional review committee. Data were derived from medical records of patients and operation logbooks with the consecutive sampling method. Data were analyzed with the help of the Statistical Package for Social Sciences (SPSS) version20 and p value < 0.05 was considered significant.  Results: Total of 105 patients with intestinal stomas was included for the study of which 82.9% (n=63) were emergency operations and 17.1% (n=13) were elective. There were 46 (43.80%) cases of ileostomy, 9(8.5%) jejunostomy and 50(47.6%) colostomy patients. Major indications of stoma formation were trauma 33.3% (n=35) and intestinal obstruction 22.8% (n=24). Complications were observed in 39 (37.14%) of the patients, with wound infection 11.8% (n=9) and peristomal dermatitis 11.8% (n=9) for ostomates being the commonest. Higher complications were seen with ileostomy as compared to colostomy (p=0.02) and loop ileostomy still higher than end ileostomy (p=0.00).  Conclusion: Common indications for intestinal stomas were abdominal trauma, enteric perforation, intestinal obstruction and colorectal carcinoma. Main complications included local skin problems, wound infection and retraction.

scholarly journals Outcome of various surgical procedures and their outcome following enteric perforation at Dr. Ruth K.M.Pfau, Civil Hospital, Karachi.

2019 ◽  
Vol 26 (10) ◽  
pp. 1613-1617
Author(s):  
Paras Mahesh ◽  
Syed Ahmad Sultan Ali ◽  
Zainab Abdullah Kaludi ◽  
Foad Ali Moosa
Keyword(s):  
Surgical Procedures ◽  
Prospective Observational Study ◽  
Loop Ileostomy ◽  
Skin Closure ◽  
Civil Hospital ◽  
Generalized Peritonitis ◽  
Enteric Perforation ◽  
The Mean ◽  
Study Setting ◽  
Surgical Unit

Objectives: To observe the outcome of various surgical procedures opted in patients presenting with peritonitis, following typhoid perforation. Study Design: Prospective observational study. Setting: Single surgical unit, Dr. Ruth K.M.Pfau, Civil Hospital, Karachi. Period: 37 months from December 2014 to December 2017. Material and Methods: 25 patients who were admitted from emergency department with the clinical diagnosis of peritonitis following typhoid perforation. The diagnosis of typhoid peritonitis was confirmed on histopathology with the finding of chronic inflammation not associated with granuloma/ giant cell and malignant cells. Results: Out of 25 patients there were 19(76%) male and 6(24%) female patients. The mean age± standard deviation (SD) was 29.52±15 years. Fever and abdominal pain was present in all patient. Generalized peritonitis was present in 23(92%), single perforation at terminal ileum was found in 23(92%). Whereas, loop ileostomy was the commonest procedure performed 14(56%) of patients. En masse abdominal wall closure was performed in 22(88%), however, skin closure was only possible in 11(44%) of the patients.  Wound infection was common complication noted 21(84%), whereas 2(8%) patients died during treatment. Conclusion: With reference to morbidities and mortality loop ileostomy seems to be have a good outcome. 

Ileostomy in the Treatment of Typhoid Enteric Perforation Among Patients Presenting Late in The Hospital

2021 ◽  
Vol 15 (11) ◽  
pp. 3360-3361
Author(s):  
Shandana Gul ◽  
Mahwash Anjum Shafiq ◽  
Fazal-e- Nauman
Keyword(s):  
Late Onset ◽  
Loop Ileostomy ◽  
Abdominal Distension ◽  
Late Presentation ◽  
Fecal Fistula ◽  
Surgical Department ◽  
Medical College ◽  
Enteric Perforation ◽  
Group A ◽  
One Year

Introduction: Typhoid enteric perforation is a communal acute emergency of abdomen in our hospital settings. Maximum patients in Pakistan come from rural zones and have a serious illness when presented in the laten final stages. Objective: To govern the importance of an ileostomy in cases of late presentation with enteric perforation. Study Design: A retrospective study. Place and Duration: In the surgical Department of Islam Medical College and Teaching Hospital Sialkot for one year duration from July 2020 to July 2021. Methods: 52 total patients of typhoid enteric perforation were included in our department. 5 to 32 years was the age range of patients with an average age of 16 years. Most of these patients have complaints of fever, abdominal pain, abdominal distension and vomiting Results: 52 patients with late presentation of typhoid perforation were alienated into 2 groups. All cases of group A underwent laparotomy and perforation exteriorization was done as loop ileostomy. In group A, when exteriorization was performed as the first procedure, fecal fistula was later developed in 12 cases. Ten of these cases had to be re-examined and the second perforation was found to be close to the original one. The mortality was observed in three cases. Conclusion: In a relatively normal-looking intestine, restoration of the margin, closure of the two layers of perforation, and ileostomy near the perforation are safer in the case of late onset of typhoid fever enteric perforation. Keywords: typhoid perforation, double-layer closure and ileostomy

Sign in / Sign up

Export Citation Format

Share Document