Colostomy

Definition

Colostomy is a surgical procedure that brings the end of the large intenstine through the abdominal wall. Stools moving through the intestine drain into a bag attached to the abdomen. The procedure is usually done after bowel resections or injuries and it may be temporary or permanent.

Description

The procedure is done while the patient is under general anesthesia (unconscious and pain-free). It may be done with invasive, open surgery or laparoscopically (several small incisions).  The type of approach used depends upon what other procedure needs to be performed. In general, the incision is made in the abdomen, and the bowel resection or repair is performed as needed.

For the colostomy, the end of the healthy colon is brought through the abdominal wall, and the edges are stitched to the skin of the abdominal wall. An adhesive drainage bag called a stoma appliance is secured around the opening to allow the drainage of stool.

Indications

There are a number of reasons to perform a colostomy:

• Intra-abdominal infection, such as perforated diverticulitis

• Traumatic injury to the colon or rectum (for example, a gunshot wound)

• Rectal cancer 

• Perineal wounds/fistulas

Whether a colostomy is temporary or permanent depends on the disease process or injury being treated. In most instances, colostomies can be reversed.

Risks

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing

Risks for any surgery are:

• Bleeding
• Infection

Additional risks are:

• Narrowing or obstruction of the colostomy opening (stoma)
• Development of a hernia at the incision site
• Skin irritation

Expectations after surgery

The colostomy functions to drain stool (feces) from the colon into the colostomy bag. Most colostomy stool is softer and more liquid than stool that is passed normally. The degree of liquidity of the stool depends on the location of the intestinal segment used to form the colostomy.

Convalescence

Recovery from this type of surgery is mostly related to the condition or procedure for which the colostomy was performed. Most patients are started on a special diet within 48 hours of surgery. Learning to care for the colostomy and the ostomy appliance will be necessary.

Illustrations

Colostomy- series

Page Content:

Intestinal opening