Monday, 2 April 2012

stoma


What is stoma?
stoma (Greek =mouth) is an artificial union made between 2 conduits (eg- a choledochojejunostomy) or, more commonly, between a conduit and the outside -eg a colostomy, in which faeces are made to pass through a hole in the abdominal wall into an adherent plastic bag, ideally as 1-2 formed motions/day.

Types of stoma?
  • Loop colostomy: A loop of colon is exteriorized, opened, and sewn to the skin. A rod under the loop prevents retraction and may be removed after 7d. This can be a defunctioning stoma (below), though faeces may pass beyond the loop. It is often temporary, and more prone to complications than end colostomies.
  • End colostomy: The bowel is divided; the proximal end brought out as a stoma; the distal end may be:
    • resected, eg abdominoperineal resection;
    • closed & left in the abdomen (Hartman's procedure);
    • exteriorized, forming a mucous fistula
  • Double-barrelled (Paul-Mikulicz) colostomy: The colon is brought out as a double-barrel. It may be closed using an enterotome.




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