Stomas Flashcards
Colostomy
- Description
- Location
- Content of colostomy bad
- Position on skin
Surgical opening in body between skin and hollow viscus
- Diverts faeces outside of body into bag
- Stoma made using colon
Location
- LIF
Bag content
- Solid faeces
Position on skin
- Flushed, no spout
- Enzymes are less alkali and less irritating.
Permanent end colostomies
- Indications
In cases where entire rectum is remove
- Resection of large rectal cancers
- Diverticulitis
- UC
Temporary end colostomies
- Indications
Indicated in cases where the other end of the bowel needs to be rested / to heal
- Diverticulitis
- Obstruction
Hartmann’s procedure
- Description
- Indications
Proctosigmoidectomy
- Resection of the rectum and sigmoid
- Anorectal stump left
- End colostomy
- Rectum and bowel re-anastomosed later
Indications
- Colon cancer
- Inflammation (proctitis, diverticulitis)
Loop colostomy
- description and function
- Indications
Loop of bowel brough to the surface and half-opened
- Allows faecal matter to drain without reaching distal anastomoses.
- Allows anastomoses to heal/ to be protected.
Ileostomy
- Description
- Location
- Bag content
- Flushing
Stoma created from small bowel
- Located in RIF
Stoma bag
- Liquid consitency
Spout sticking out abdominal wall
- Due to enzymes in bowel that can irritate skin
- Drains without touching skin.
Permanent end Ileostomy
- Indications
After panproctocolectomy- removal of entire colon
- UC
- FAP
Temporary end Ileostomy
- Indications
Where emergency anastomosis is not appropiate
- Emergency bowel resection
Urostomy
- Description
- Indication
- Bag contents
Where an ileal conduit is used as a route for urine to exit of the abdomen
- Piece of ileum is resected an spouted with ureters attached to end of the bowel.
Indication
- After cystectomy
Bag content
- Urine
Immediate complications of stoma surgery
General complications of surgery
- PE/ DVT
- Pneumonia
Psychological
Stoma bleeding
Wound infection
Late complications of stoma
Stoma retraction/ prolapse
Parastomal hernia
Fistula variceal bleeding
Bowel obstruction
Skin/ ulcer problems
Vit B12 deficiency
Stoma stricture
Early complications of stoma
Dehydration (high output)
Rectal discharge
