Lower GI Stoma

Question 1

What types of patients may need a stoma?

Answer 1

• Cancer or anus or rectum
• Crohns or UC
• diverticular disease
• faecal incontinence
• obstruction
• trauma

Question 2

Describe a loop colostomy?

Answer 2

Loop of colon pulled out into abdomen and held in place with rod.

Question 3

Describe a double-barrelled colostomy?

Answer 3

Diseased portion of colon is isolated and 2 ends are brought through abdominal wall.

Question 4

Are both stomas active in a double-barrelled colostomy?

Answer 4

no - usually the upper one diverts faeces to the colostomy bag and the lower allows the lower part of the bowel to heal - can then be rejoined.

Question 5

Describe a Hartmann’s procedure?

Answer 5

Descending colon is brought to stoma and the distal end is sewn over and left in the abdomen.

Question 6

Is a Hartmann’s stoma permanent or temporary?

Answer 6

It can be both temporary or permanent.

Question 7

When might an ileostomy be required?

Answer 7

Crohns,
UC,
Obstruction

Question 8

Describe a loop ileostomy?

Answer 8

Loop brought to the surface of the skin and a spout is formed.

Question 9

What considerations need to be made for loop ileostomy?

Answer 9

• Protection of the skin - proteolytic enzymes contained in liquid.
• Drainable pouch and leave in place for 1-2 days.

Question 10

What is a Koch’s ileostomy?

Answer 10

Where effluent from ileostomy is collected in sac/value in abdomen.