Chapter 42: Ostomies Flashcards
Ostomy
Operation that connects the GI tract to abdominal wall skin or the lumen of another hollow organ; a man-made fistula
Stoma
Opening of the ostomy (Greek mouth)
Gastrostomy
G-tube through the abdominal wall to the stomach for drainage or feeding
Jejunostomy
J-tube through the abdominal wall to the jejunum for feeding
Colostomy
Connection of colon mucosa to the abdominal wall skin for stool drainage
End colostomy
Proximal end of colon brought to the skin for stool drainage
Mucous fistula
Distal end of transected colon brought to the skin for decompression; the mucosa produces mucus, an ostomy is a fistula, and, hence, the term mucous fistula (proximal colon brought up as a colostomy or, if the proximal colon is removed, an ileostomy)
Hartmann’s pouch
Distal end of transected colon stapled and dropped back into the peritoneal cavity, resulting in a blind pouch; mucus is decompressed through the anus (proximal colon is brought up as an end colostomy or, if proximal colon is removed, an end ileostomy)
Double-barrel colostomy
End colostomy and a mucous fistula (i.e., two barrels brought up to the skin)
Loop colostomy
Loop of large bowel is brought up to the abdominal wall skin and a plastic rod is placed underneath the loop; the colon is then opened and sewn to the abdominal wall skin as a colostomy
Brooke ileostomy
Ileostomy folded over itself to provide clearance from skin
Why doesn’t an ileostomy or colostomy close?
Epithelialization (mucosa to skin) from the acronym FRIEND
Why doesn’t a gastrostomy close?
Foreign body (the plastic tube) from the acronym FRIEND
If the plastic tube, G-tube, or J-tube is removed, how fast can the
hole to the stomach or jejunum close?
In a matter of hours! (Therefore, if it comes out inadvertently from a well established tract, it must be replaced immediately)
What is a “tube check”?
Gastrografin contrast study to confirm that a G-tube or J-tube is within the lumen of the stomach or jejunum, respectively