The Complications Of Colostomy

Colostomy is a technique for an opening in the abdomen and it could cause about 40% of complications due to the technique.

Edema:
All the stomata are edematized right away after the intervention because of the bowel manipulation. However, the edema will diminish gradually during the next weeks as well as the size will be built in six weeks. It is crucial to observe the progress, and the size should be regularly measured so that the edge opening is correctly cut.

Necrosis and Ischemia:
It generally manifests in the first 24 hours after the operating period, and might even appear during the operating before the end of intervention. The mucosa on the stoma could change color from the reddish to grayish blackish. The ischemia could be superficial to the mucosa or extending into the peritoneal cavity, and it will determine the following action.

Mucocutaneous Separation:

Mucocutaneous separation occurs if there is a splitting of the suture line, which affixes the stoma on the surface of the abdomen as well as leaves the cavity in the wound. Mucocutaneous separation could be treated by using stoma pastes as well as an adhesive washer.

Stenosis:
Stenosis happens when the stoma opening becomes narrow, and it occurred probably because of the establishment of the non-elastic tissue after the retraction, necrosis and mucocutaneous separation. Stenosis is typically characterized by abdominal pain as well as the difficulty in expelling stool. In general, the treatment for stenosis includes instructing the patients to keep the stools soft through diet and using faecal softening drugs like lactulose, and also introducing a dilator to the stoma lumen in order to keep it permeable. The long-term treatment for stenosis might require the patient to have surgical reshaping the stoma.

Infection:

Infection is among the most frequent complications of Colostomy. It has clinical pain in the stomal area with the signs of inflammation. Infection could occur more frequently with the interventions performed urgently because of the lack of colon preparation.

Retraction:
Retraction is called, due to sinking of the stoma down below the level of skin. It is often caused by the excessive bowel tension, generally because of the lack of mobilization, while also in many occasions the patient’s gaining weight could favor it the same as postoperative ileus, hyperpressure abdominal pain, and peristomal septic complications. When the degree of retraction gets important, it could also have stenosis with an ostomotic mouth, which could cause difficulty to pass stools that require a surgical reconstruction.

Evisceration:
Evisceration is a complication that has a low incidence. If the hole in the abdominal wall is too big related to the diameter of stoma, either because of an internal abdominal hyperpressure, or because the wall of abdomen is hypoplastic, one of those bowel loops could come out of the hole.

Prolapse:
Prolapse is the over-exteriorization of the colon because of the puffiness resulting from the increase of the intra-abdominal pressure or from the incorrect fixation of colon. The size could vary and reach up to 15-20 millimeters. It could occur suddenly, but in most of the cases, it appears progressively. The factors that could increase the chance for a prolapse include age, the existence of disease before the ostomy, the bowel movements, and all conditions that could increase the intra-abdominal pressure such as cough.