Early postoperative complication of ileostomy
Ans. is 'd' i.e. Necrosis "Stoma necrosis may occur in the early postoperative period and usually is caused by skeletonizing the distal small bowel and/or creating an overly tight fascial defect. Schwartz 9/e pl031Stomal ComplicationsCategoryComplication EarlyLateStomaPoor locationProlapse RetractionStenosis Ischemic necrosisParastomal hernia DetachmentFistula formation Abscess formationGas Opening wrong endOffensive OdourPeristomal skinExcoriationParastomal varices DermatitisDermatoses Cancer Skin manifestations of inflammatory bowel diseaseSystemicHigh outputBowel obstruction NonclosureMay also develop as a late complication.Other complications are:DiarrheaUrinary tract calculiGallstonesImportant points about OstomiesAn intestinal stoma is an opening of the bowel onto the surface of the abdomen.Depending upon the clinical situation, a stoma may be temporary or permanent. It may be end-on or a loop.A temporary ileostomy often is used to "protect" an anastomosis that is at risk for leakage (low in the rectum, in an irradiated field, in an immunocompromised or malnourished patient, and in some emergency operations). In this setting, the stoma often is constructed as a loop ileostomy.A permanent ileostomy sometimes is required after total proctocolectomy or in patients with obstruction. An end ileostomy is the preferred configuration for a permanent ileostomy.Most colostomies are created as end colostomies rather than loop colostomies. The bulkiness of the colon makes a loop colostomy awkward for an appliance, and prolapse is more likely with this configuration.However, regardless of the indication for a stoma, placement and construction are crucial for function.A stoma should be located within the rectus muscle to minimize the risk of a postoperative parastomal hernia.It also should be placed where the patient can see it and easily manipulate the appliance.The surrounding abdominal soft tissue should be as flat as possible to ensure a tight seal and prevent leakage.The optimal position for an ileostomy is in the right lower quadrant.The most desirable position for a sigmoid or descending colostomy is usually in the left lower quadrant of the abdomen. However, if the patient is obese, it may be preferable to site the colostomy in the left upper quadrant so that it is visible to the patient and not trapped on the undersurface of a panniculus. If a distal transverse colostomy is planned, the left upper quadrant is usually the preferable site.The left colon should be used for a colostomy if possible; the distal transverse colon is also a reasonable choice. Proximal colostomies should be avoided, as they will combine the worst features of both a colostomy and an ileostomy: liquid, high-volume, foul-smelling effluent.Parastomal hernia is the most common late complication of a colostomy.Parastomal hernia is less common after an ileostomy than after a colostomy.Most common indication:According to Maingot's Abdominal Operations, the most common indication for an ostomy is Ulcerative colitis, followed by Colorectal cancer.Most common indication for ileostomy is Inflammatory bowel disease (Ulcerative colitis).The most common indication for a colostomy is colorectal cancer.
Obstruction
Prolapse
Diarrhoea
Necrosis
Miscellaneous (Small & Large Intestine)