Stomas

Question 1

Give an example of when a temporary end ileostomy would be created

Answer 1

During an emergency bowel resection where it is unsafe to form an anastomosis with remaining bowel at that time (e.g. disease bowel, intra-abdominal sepsis, bleeding).

Question 2

What is the indication for a temporary end colostomy?

Answer 2

To allow bowel rest e.g. diverticulitis, obstruction, leak.

Question 3

Define stoma

Answer 3

Artificial openings of a hollow organ onto surface of abdomen to allow faeces/urine to drain.

Question 4

What is used to collect the waste products from a stoma?

Answer 4

Stoma bag

Question 5

Define colostomy and give 3 features of it

Answer 5

Colon brought onto skin.
Drains more solid stools, non-spouted and located if LIF.

Question 6

Define ileostomy and give 3 features of it

Answer 6

Ileum brought onto skin.
Drains more liquid stools, spouted and located in RIF.

Question 7

Define urostomy and give 4 features of it

Answer 7

Opening from urinary system onto skin.
Drains urine, spouted, located in RIF and ileal conduit acts as bladder.

Question 8

What is the indication for a urostomy?

Answer 8

Post cystectomy

Question 9

How is an ileal conduit created?

Answer 9

Section of ileum removed and ureters anastomosed to ileum. End section of ileum brought onto skin as a stoma draining urine from ureters into urostomy bag.

Question 10

What is an end colostomy/ileostomy?

Answer 10

End part of proximal bowel is brought onto skin and open end of distal bowel is sutured and left in abdomen.

Question 11

What is the indication for a permanent end colostomy?

Answer 11

Abdomino-perineal resection (APR)

Question 12

What is the indication for a permanent end ileostomy?

Answer 12

Panproctocolectomy

Question 13

Describe a loop colostomy/ileostomy

Answer 13

Temporary stoma to allow distal bowel end to heal after surgery or decompress in bowel obstruction. Bowel is partially opened and folded, the 2 openings onto skin side-by-side. Proximal end is spouted and distal end is non-spouted.

Question 14

List the possible complications of stomas

Answer 14

Psycho-social impact
Local skin irritation
Parastomal hernia
Loss of bowel length leading to high output, dehydration and malnutrition
Constipation (colostomies)
Stenosis
Obstruction
Retraction (sinking into the skin)
Prolapse (telescoping of bowel through hernia site)
Bleeding
Granulomas causing raised red lumps around the stoma