scholarly journals Prospective study of 30 cases of temporary ileostomy and their complication

2021 ◽  
Vol 8 (3) ◽  
pp. 831
Author(s):  
Manish Chaudhari ◽  
Deval Parikh ◽  
Jigar Aagja ◽  
Vedant Wankhede
Keyword(s):  
Abdominal Wall ◽  
Loop Ileostomy ◽  
Skin Irritation ◽  
Conservation Of Resources ◽  
Ileal Perforation ◽  
Proximal Small Bowel ◽  
Intestinal Stoma ◽  
Peristomal Skin ◽  
Technical Factors ◽  
Complete History

Background: An intestinal stoma is an opening of the intestine or urinary tract onto the abdominal wall, constructed surgically or appearing inadvertently. An ileostomy involves exteriorization of the ileum on the abdominal skin. In rare instances, the proximal small bowel may be exteriorised as a jejunostomy. A colostomy is a connection of the colon to the skin of the abdominal wall.  Methods: Data of patients, who were undergone for ileostomy construction in New Civil Hospital, Surat were collected prospectively regarding complete history, clinical features on examination, investigations and management. Results: The most common indication of ileostomy formation was ileal perforation in 46.6% patients followed by Intestinal obstruction in 16.6% patients, obstruction with gangrene in 13.3% patients, adhesion in 10% patients. In total of 30 patients loop ileostomy was performed in 17 patients and double barrel ileostomy in 13 patients. Peristomal skin irritation was the most common complication (90%) cases, followed by stomal necrosis/retraction (3.3%). Complications were recorded in all patients out which stomal complication seen in 96% of cases (29 out of 30). Of these peristomal skin excoriation was most common (90%) followed by wound related complications, present in 36.6% cases (11 out of 30 patients).Conclusions: In case of a high complication procedure like ileostomy, it is important to know regarding factors which can be avoided and managed. Knowing these factors which can be avoided or managed. Knowing these factors may help in attributing complications to surgical or technical factors, thereby providing opportunity to correct this error. Prediction of ileostomy complication helps in better management before occurrence of complication. It also helps in conservation of resources and better patient outcome.

scholarly journals Comparison between Tube Ileostomy and Loop Ileostomy as a Diversion Procedure

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Vijayraj Patil ◽  
Abhishek Vijayakumar ◽  
M. B. Ajitha ◽  
Sharath Kumar L
Keyword(s):  
Loop Ileostomy ◽  
Skin Irritation ◽  
Ileostomy Closure ◽  
Complication Rates ◽  
Saline Irrigation ◽  
Feeding Jejunostomy ◽  
Ileal Perforation ◽  
Common Etiology ◽  
Peristomal Skin ◽  
Tube Versus

Aim. Loop ileostomy has high complication rates and causes much patient inconvenience. This study was performed to compare the outcome of tube versus loop ileostomy in management of ileal perforations. Patients and Methods. From July 2008 to July 2011, all patients with ileal perforation on laparotomy where a defunctioning proximal protective loop ileostomy was considered advisable were chosen for study. Patients were randomly assigned to undergo either tube ileostomy or classical loop ileostomy as the diversion procedure. Tube ileostomy was constructed in the fashion of feeding jejunostomy, with postoperative saline irrigation. Results. A total of 60 diversion procedures were performed over the period with 30 for each of tube and loop ileostomy. Typhoid and tuberculosis formed the most common etiology for ileal perforation. The complication rate of tube ileostomy was 33%. Main complications related to tube ileostomy were peritubal leak, tube blockage. In patients with loop, overall complications in 53% majority were peristomal skin irritation and wound infection following ileostomy closure. Two patients developed obstruction following ileostomy closure which needed reoperation. Conclusions. Tube ileostomy is effective and feasible as a diversion procedure and has reduced morbidity. It can be used as an alternative to loop ileostomy.

scholarly journals Management of Stomal Complications

1995 ◽  
Vol 9 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Svante R Nordgren
Keyword(s):  
Skin Irritation ◽  
Rectus Muscle ◽  
The Elderly ◽  
Infectious Complications ◽  
Surgical Skill ◽  
Stomal Complications ◽  
Intestinal Stoma ◽  
Extraperitoneal Colostomy ◽  
Peristomal Skin ◽  
Sigmoid Colostomy

Creation of an intestinal stoma, be it temporary or permanent, requires good judgement and surgical skill. For the patient the stoma is of constant concern, and a well constructed intestinal stoma can reduce the patient's physical and psychological stress. Peristomal skin irritation should alert a search for surgical complications. Collaboration with an enterostomal therapist is strongly advised. The probability of revision of an ileostomy during the first 10 years reaches 0.44 in patients with ulcerative colitis (UC) and 0.75 in patients with Crohn's disease (CD). The most frequently seen complication are stenosis and sliding retraction. Stomal fistulas are seen more frequently in patients with CD than those with UC. Most ileostomy complications can be treated locally, without a laparotomy. The sigmoid colostomy, a stoma of the elderly, is also frequently complicated by stenosis, particularly after postoperative infection and separation at the mucocutaneous junction. Peristomal herniation is extremely common, and some degree of herniation is almost inevitable. There are no randomized studies to determine the best way to construct a colostomy. Bringing the bowel through the rectus muscle is probably superior to lateral to the muscle. Extraperitoneal colostomy does not provide any advantage over the intraperitoneal route. A colostomy stenosis is best managed locally. Infectious complications and hernias require laparotomy and resiting of the stoma.

scholarly journals Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

2008 ◽  
Vol 23 (3) ◽  
pp. 294-303 ◽  
Author(s):  
Katia Ferreira Güenaga ◽  
Suzana Angélica Silva Lustosa ◽  
Sarhan Sydney Saad ◽  
Humberto Saconato ◽  
Delcio Matos
Keyword(s):  
Large Scale ◽  
Loop Ileostomy ◽  
Skin Irritation ◽  
Colorectal Anastomosis ◽  
Length Of Hospital Stay ◽  
Transverse Colostomy ◽  
Time Interval ◽  
Stoma Formation ◽  
Statistical Heterogeneity ◽  
Stoma Prolapse

PURPOSE: The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. METHODS: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. RESULTS: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I² = 0% for the heterogeneity test. CONCLUSIONS: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials.

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 Technical Considerations in Stoma Creation

2017 ◽  
Vol 30 (03) ◽  
pp. 162-171 ◽  
Author(s):  
Alia Whitehead ◽  
Peter Cataldo
Keyword(s):  
Quality Of Life ◽  
Abdominal Wall ◽  
Preoperative Planning ◽  
Intestinal Segment ◽  
High Quality ◽  
Stoma Creation ◽  
Patient Will ◽  
Intestinal Stoma ◽  
Technical Considerations

AbstractCreating an intestinal stoma is commonly the final aspect of an often emergent and complicated operation under difficult circumstances. While creation of a protruding, tension-free, and well-vascularized stoma is often straightforward, one must be prepared for challenging situations such as a thick abdominal wall and short, thickened mesentery. A successful stoma starts with attentive preoperative planning including site marking, thoughtful consideration of alternatives, and attention to technical detail. The tips provided in this article should facilitate the process of selecting the appropriate intestinal segment, identifying the correct stoma site, and creating a functional stoma even in the most challenging situations. Constructing a high-quality stoma will decrease complications and improve the patient's quality of life. Stoma creation is frequently the only component of an operation that the patient will have to live with for the remainder of his/her life.

scholarly journals Defunctioning loop ileostomy: not always a safe option

2011 ◽  
Vol 93 (6) ◽  
pp. e74-e76
Author(s):  
Philip T Davey ◽  
Nathan Burnside ◽  
Niall MacKenzie ◽  
David Conkey ◽  
James Carson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Skin Necrosis ◽  
Anterior Abdominal Wall ◽  
Loop Ileostomy ◽  
Rectal Adenocarcinoma ◽  
Extensive Area ◽  
Lower Abdominal Wall

A 74-year-old woman underwent a low anterior resection and defunctioning loop ileostomy for a T1 N1 M0 rectal adenocarcinoma. Three months following surgery she attended complaining of pain inferior to the loop ileostomy. A clinical examination demonstrated an extensive area of spreading cellulitis on the lower abdominal wall inferior to the loop ileostomy with associated crepitus and skin necrosis. The clinical diagnosis of necrotising fasciitis was confirmed radiologically on emergency computed tomography. The patient underwent an emergency debridement of the anterior abdominal wall.

scholarly journals Knowledge and Practice of Stoma Care among Ostomates at B.P.Koirala Memorial Cancer Hospital

2015 ◽  
Vol 4 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Radha Acharya Pandey ◽  
Sandhya Baral ◽  
Govinda Dhungana
Keyword(s):  
Skin Irritation ◽  
Self Care ◽  
Care Practice ◽  
Psychomotor Skills ◽  
Permanent Colostomy ◽  
Cross Sectional ◽  
Significant Difference ◽  
Peristomal Skin ◽  
Knowledge And Practice ◽  
Stoma Care

Background: There are more than 1 million patients with a permanent colostomy and the number is increasing by the rate of 100 000 per year. Clients with a new stoma must master multiple psychomotor skills to remove their pouch, clean the stoma and peristomal skin and empty and dispose of effluent from the pouch. Stoma care self-efficacy has been positively related to ostomy adjustment.Objective: To assess knowledge and practice of stoma care among ostomates.Method: This is a simple descriptive cross sectional study. A total of 94 ostomates who met eligible criteria were purposively sampled. Stoma self care efficacy scale and semi-structured questionnaire was used and face to face interview was done. Data were analyzed using SPSS version 16 program. T test was used to see the mean difference.Result: The knowledge of ostomates on normal stoma and complication of stoma was adequate (61.7%). Majority (92.6%) respondents had good daily care practice like emptying pouch, hand washing before and after procedure and cleaning stoma. Majority of the ostomates suffered from physical problem (89.4%). Of which maximum 72.3% had peristomal skin irritation, then came leakage and odour. More than half (64.9%) of ostomates had higher efficacy.Conclusion: On the basis of findings, it is concluded that there was significant difference in mean knowledge of ostomates with variables pre-operative teaching, training on stoma care, living with stoma for more than 12 months. There was significant difference in mean self care efficacy with variables duration of living with stoma and training on stoma care. Thus training on stoma care should be provided frequently to further improve self care efficacy.Journal of Nobel College of Medicine Vol.4(1) 2015: 36-45

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.

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