What are the indications for colostomy?
General Surgeons in Lahore perform the life-saving procedure of colostomy, for either the diversion of stool, or decompression of obstructed colon. Depending on the underlying condition, both temporary and permanent types of colostomies are done. Read on to know more about colostomy, its indications, types and complications:
What are the indications of colostomy?
The indications of colostomy include:
Diverticulitis:
- in this condition, small pouches appear in the wall of the colon, which can become infected and inflamed. Diverticulum formation is more in the elderly and can cause high grade fever, vomiting and abdominal pain. If diverticulitis does not improve with antibiotics, the healthcare provider may choose resection of the colon, with temporary colostomy, to allow for healing of the colon.
Crohn’s disease:
- this is part of the inflammatory bowel disease (IBD), which is autoimmune. In Crohn’s, the gut is inflamed, which is why temporary colostomy is done to help in healing. If need be, permanent colostomy is performed combined with colectomy.
Colon cancer:
- one of the commonest reasons for colostomy is colo-rectal cancers. In the scenario of colon cancer, the affected part along with the regional lymph nodes is resected. This is followed by temporary or permanent colostomy to allow healing of the remaining colon. Once the anastomosed colon is healed, the colostomy is reversed. If the cancer is in more distal location, the rectum and anus are removed, followed by permanent colostomy.
Hirschsprung’s disease:
- the rare genetic disorder of Hirschsprung’s warrants colostomy to be performed in children. In this disease, the muscular part of the gut is denervated and thus easily becomes blocked. To deal with these blockages, part of the damaged colon is removed, and during this time, temporary or permanent colostomy is done.
Bowel obstruction:
- medical emergency of obstructed bowel can arise secondary to conditions like colorectal cancers or severe constipation. In such cases there is risk of infection and sepsis if the walls of colon rupture. Temporary or permanent colostomy is then performed as part of the treatment.
Bowel injury:
- injury to the gut, such as in traffic accident, gunshot wound or knife injury may damage the colon enough that temporary colostomy needs to be performed. During this time, the fecal matter is diverted away from the injured part of the gut, so healing can occur. If the gut is so damaged that part of it is excised, colostomy may be permanent, as well.
Bowel incontinence:
- if a person is unable to exert control over their bowel movement, it is called bowel incontinence. In most cases, colostomy is a last resort for this condition.
What are the types of colostomy?
There are two main types of colostomy:
End colostomy
Most end-colostomies are of permanent type, though sometimes temporary end-colostomies are performed in emergency settings. In end colostomy, one end of the colon forms the stoma or opening, while the other end going to the rectum is sealed off. This sealed end is left inside the abdomen, while the stoma-forming end is stitched to the skin. Mostly, the site of the stoma is left iliac region below the belt line. Through this end, the waste products will pass through.
Loop colostomy
As the name implies, a loop of colon is pulled through the incision in the abdomen and stitched to the skin to form a stoma. The stoma has two openings—one from which the waste products leave—and one which is connected to the inactive part of the rectum. A loop colostomy is temporarily done for the conditions mentioned before. As with end colostomy, the location of stoma of loop colostomy is left iliac region, below the belt line.
What are the complications of colostomy?
After the procedure, certain complications can occur. These include:
- Rectal discharge
- Stoma blockage
- Irritation of skin
- Stomal fistula
- Leakage
- Prolapse of stoma
- Stricture of stoma
- ischemia of stoma, which may need further expertise of a General Surgeon in Karachi for management.
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