Stomas Flashcards
What is a stoma?
An artificial opening of a hollow organ allowing urine or faeces to drain
What is a colostomy?
where the large bowel/colon is brought onto the skin
Colostomy drain more solid stools as most of the water is reabsorbed in the remaining large intestine
how may colostomies differ in appearance compared to ileostomies?
colostomies may look flatter on the skin, whereas Ileostomies have to have a ‘spout’
colostomies typically located in the left iliac fossa, ileostomies are usually located in the right iliac fossa
What are ileostomies?
From the small bowel
More liquid stool as water reabsorbed in the large intestine
Have a spout, and tight-fitting stoma bag because looser stools are more irritating to the skin
Typically in right iliac fossa
What is a gastrostomy?
Artificial connection between the stomach and the stomach and abdominal wall
Used to put things (Feeds) in rather than take things out
E.g. PEG
What is a Percutaneous Endoscopic Gastrostomy (PEG)?
Fitted during an endoscopic procedure
a procedure in which a flexible feeding tube is placed through the abdominal wall and into the stomach. PEG allows nutrition, fluids and/or medications to be put directly into the stomach, bypassing the mouth and esophagus.
What is a urostomy?
opening from the urinary system onto the skin typically in right iliac fossa
Typically have a spout to avoid urine coming into contact with the skin and a bag
What is an end colostomy?
Created after the removal of a section of the bowel where the end part of the proximal portion of bowel is brought onto the skin + drain out into the stoma bag
and the distal part of the bowel is sutured and left inside the abdomen
An end colostomy may be reversed where the two ends are sutured together to form an anastomosis
Will be permanent after an abdomino-perineal resection (APR) because the entire rectus and anus have been removed
usually located in the lower left abdomen
What is an end ileostomy?
Permanent - after a panproctocolectomy which is a total colectomy with removal of the large bowel, rectum and anus
May be performed in the treatment of IBD, familial adenomatous polyposis (FAP)
typically right iliac fossa (man seen in GP with no anus and stoma)
What is an alternative to creating a permanent end ileostomy?
Ileo-anal anastomosis (J-pouch)
Ileum is folded back on itself an and functions like a rectum
The J pouch is connected to the anus and collects stools
What is a loop colostomy/ileostomy?
Colostomy used to allow the distal part of the bowel and the anastomoses to heal after surgery before the loop colostomy is reversed 6-8 weeks later
The bowel is partially folded and opened so that there are 2 openings on the skin side by side that are attached to each other in the middle.
The proximal end is productive and a spout is formed so stools come out
The distal end is more flat
About Urostomies?
used to drain urine from the kidney bypassing the ureters, bladder and urethra
may be used after a cystectomy (removal of bladder)
Involves creating a ileal conduit:
- 15-20cm of the ileum is removed and and end-to-end anastomosis is created so the bowel function is not affected
- Ends of the ureters are attached to the portion of the ileum and the end of this section is brought to the skin as a stoma which drains the urine
Bag needs to be tightly fitted to avoid urine coming into contact with the skin
Complications of stomas:
Psycho-social impact
Localised skin irriation
Parastomal hernias
