A colostomy is an artificial opening in the large bowel, diverting waste to an external appliance. There are various types of colostomies categorized by their duration (temporary or permanent), anatomic location, and function, with indications ranging from obstructing lesions to fecal incontinence. Postoperative management and potential complications such as prolapse, necrosis, and hernias are also discussed.

1. COLOSTOMY
Dr Bashu Dev Baskota
1st
yr resident

2. Definition:an artificial opening made
in the large bowel to divert faeces
and flatus to the exterior,where it
can be collected in an external
appliance.

3. Types of stomas:

4. Types of colostomy:
1)Temporary colostomy
2)Permanent colostomy
Types by anatomic location:
-end sigmoid colostomy
-end descending colostomy
-transverse colostomy
-cecostomy

5. Types by function:
-decompressing colostomy (blow hole
type,tube type of cecostomy,loop
transverse colstomy)
-diverting colostomy

6. Indications of Temporary colostomy:
a)distal obstructing lesion
b)severe sigmoid diverticulitis
c)sigmoid volvulus
d)pseudo-obstruction syndromes seen in
immunocompromised and elderly
e)anorectal malformations
f)pt. with massive distention and
impending perforation of colon

7. Permanent colostomy indications:
a)suspected obstruction or
perforation of distal bowel with APR
or Hartmann’s operation
b)idiopathic fecal incontinence

15. Preoperative:
1)Bowel preparation
2)Anaesthesia

20. Selecting the site

23. Stoma measuring guide

48. Postoperative:
a)General management
b)Care of the colostomy

51. Complications of colostomies:
1.prolapse
2.retraction
3.necrosis of distal end
4.fistula formation
5.stenosis of the orifice
6.colostomy hernia
7.bleeding
8.colostomy diarrhoea

53. Ileostomy with gaping mucocutaneous
separation

54. Prolapsed partially ulcerated colostomy loop

58. A)Large parastomal
hernia around end
sigmoidostomy
B)huge paracolostomy
hernia with laterally
displaced ostomy opening

59. True parastomal hernia

60. Subcutaneous hernia(pseudohernia)
with intact fascial ring

61. Intrastomal hernia (may be associated with prolapse)

62. Repair of parastomal hernia

63. A)adenocarcinoma following sigmoidostomy
B)exophytic polypoidal mass surrounding
ileostomy

64. poorly sited stomas in obese patient
h

65. Improperly placed stomas