Stoma Flashcards
ESSENCE
Artificial opneings of a hollow organ (such as bowel), allowing it to drain
Stoma bag is fitted around stoma to collect waste products and emptied as required
What are the different procedures that use stomas?
- Colostomy
- Ileostomy
- Gastrostomy
- Urostomy
What is colostomy
- Large intestine brought onto skin
- Draisn more solid stools as much of water is reasborbed in remaining large intesting
- Can be flatter to skin as solid contents are less irritating to skin
Where are colostomies typically located
Left iliac fossa
What is ileostomy
- End portion of small bowel (ileum) brought onto skin
- Drains more liquid stools as fluid normally reabsorbed later in large intestine
- Need spout to avoid contact with skin
Where are ileostomy typically located
Right iliac fossa
What is gastrotomy
- Artificial connection between stomach and abdominal wall
- Used to provide feeds directly to stomach in patients that cannot meet nutritional needs by mouth
What is PEG
Percutaneous endoscopic gastrotomy - gastrotomy fitted by an endoscopy procedure
What is urostomy
- Opening from urinary system onto skin
- Needs sprout to avoid skin contact
Where is urostomy typically located
Right iliac fossa
What is an end colostomy
- Created after removal of section of bowel where end of proximal portion is brought to skin and faeces able to drain out into stoma bag
- Other end remains in bowel sutured, may be reversed at later date where two ends are sutured together
When are end colostomy permanent
After resection of abdomino-perineal resection (APR) because entire rectum and anus has been rmeoved
When does end ileostomy become permanent
After panproctocolectomy (total colectomy with removal of large bowel, rectum and anus) such as in IBD or FAP
What is alternative to end ileostomy
- Ilio-anal anastomosis (J pouch)
- Ileum folded back on itself and made into larger pouch that functions like rectum, attached to anus and can collect stool prior to passage
What is loop colostomy
- Temporary colostomy used to allow distal portion of bowel and the anastomosis to heal after surgery, before being reversed 6-8 weeks later
- Bowel partially opened and folded so two openings on skin side by side, attached in the middle
