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Original Research

RMJ. 2010; 35(2): 198-200


Frequency of complications of ileostomy: experience of 180 cases at Chandka Medical College Hospital Larkana

Yasmeen Bhatti, Imamuddin Baloch, Ghulam Shabir Shaikh, Rajib Ali Deenari, Sameena Naz.

Abstract
ABSTRACT
Objective
To evaluate the frequency of complications of ileostomy.
Patients and Methods
This descriptive study was conducted on 180 patients at surgical units of Chandka Medical College Hospital, Larkana from August 2004 to February 2008. Patients of ileostomies performed for various pathologies including enteric perforation, intestinal obstruction, abdominal tuberculosis and abdominal trauma were enrolled. Preoperative preparation, investigations, operative findings and post operative complications were noted.
Result
A total of 180 patients were evaluated. Age ranged between 12-65 years (mean 29+13.31years). Male to female ratio was 1:1.22. 93(51.6%) patients were of enteric perforation followed by 49(27.2%) of intestinal obstruction, 20 (11.1%) of abdominal tuberculosis and 18(10%) of abdominal trauma. 72 (40%) patients developed variable complications; of which 38(21.1%) developed skin excoriation, 12(6.6%) retraction, 8(4.4%) stenosis, 8(4.4%) stomal prolapse, 3(1.6%) peristomal sepsis, 2(1.1%) ischemia and one(0.5%) bleeding. Mortality rate was zero.
Conclusion
Complications of ileostomy are common and most of them are manageable conservatively. (Rawal Med J 2010;35: ).
Key words
Ileostomy, complications, stoma, skin excoriation, prolapse.

INTRODUCTION

The word “Stoma” comes from the greek word meaning mouth or opening.1
Ileostomy is a surgically created opening in the small bowel (ileum) on to the anterior abdominal wall to divert intestinal contents. Those consisting of a single intestinal lumen are termed end ileostomy, those giving access to an afferent and efferent limb may be loop or double barreled ileostomy. It may be temporary or permanent depending on their role.2 An ileostomy was first advocated in ulcerative colitis in 1912 but was not widely used until Brooke demonstrated his everted ileostomy in 1952.3
The ileostomy is created by bringing the terminal small bowel through a trephine incision preferably through the rectus muscle and then creating an everted spout of 2-3cm in length.4 Defunctioning loop ileostomies are used commonly to protect low colorectal anastamosis and thereby reducing the serious complications of leakage.5 While Ileostomy causes physical and emotional trauma to patient, it is a life saving procedure. 6 Complications associated with stoma are frequent and their impact ranges from simple inconvenience to life threatening.7 Complication rates specific to loop ileostomies can be significant, ranging from 5.7% to 41%.8 The aim of this study was to evaluate the frequency of complications of ileostomy in elective and emergency surgery.
PATIENTS AND METHODS
This study was conducted in the surgical department of Chandka Medical College Hospital, Larkana from August 2004 to February 2008. A total of 180 patients of ileostomies operated for various pathologies were evaluated. All were admitted through emergency department and had detailed history, thorough clin

Key words: Ileostomy, complications, stoma, skin excoriation, prolapse.



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