This document provides information on colostomies, including definitions, indications, classifications, formation, care, closure, and complications. A colostomy is a surgical procedure that brings a portion of the large intestine through the abdominal wall. Indications include congenital diseases like Hirschsprung's disease and acquired diseases such as colorectal cancer. Colostomies are classified based on purpose, function, site, type of surgery, and more. Formation involves pre-operative counseling and preparation, careful intra-operative technique, and post-operative care and monitoring. Ongoing colostomy care focuses on mechanical, dietary, skin, and psychological aspects. Complications can arise from formation, closure, or long-
This document provides information about colostomies, including:
1. A colostomy is a stoma of the colon that diverts fecal matter and flatus by creating an opening between the colon and skin.
2. Indications for colostomy include both congenital conditions like Hirschsprung's disease and acquired conditions like intestinal obstruction, gangrenous bowel, or protecting a bowel anastomosis.
3. Colostomies can be classified temporally as temporary or permanent, anatomically by the portion of colon used, or constructionally as loop or divided depending on if the bowel is divided or intact.
An ostomy is a surgically created opening in the intestine that allows for waste to exit the body into an external bag. There are two main types - an ileostomy, which is created from the small intestine, and a colostomy, which is created from the large intestine. An ostomy may be temporary or permanent and is usually required due to conditions like cancer, IBD, or injury. Attaching the external bag securely is important to prevent complications. Diet and lifestyle adjustments are also needed after an ostomy is created.
This document discusses intestinal stomas, including definitions, types, indications, and routine care. It covers colostomies and ileostomies, which are surgically created openings of the small or large intestine onto the abdominal wall. Complications are also summarized, such as dermatological issues, bleeding, necrosis, retraction, hernias, and prolapse. The document provides overview on prevention, risk factors, signs, and management of various stoma-related complications.
This document discusses colostomy care and procedures. It defines a colostomy as an artificial opening in the large intestine brought to the surface of the abdomen. It then classifies colostomies as either temporary or permanent, and by stoma site or number/type. Common indications for a colostomy include colon cancer, Hirschsprung's disease, and ulcerative colitis. The purpose of colostomy care is to protect the skin, provide drainage, clean and regulate the bowel, and enable patient self-care. Required equipment includes supplies for changing appliances and bags, as well as accessories like filters, tape, soap, and gloves. Colostomy irrigation is defined as introducing a solution through the
This document discusses colostomies and ostomy care. It describes common medical conditions that may necessitate an ostomy, including imperforate anus, Hirschsprungs disease, inflammatory bowel disease, necrotizing enterocolitis, and spina bifida. It then focuses on ileostomies and colostomies, describing the differences and care involved. The document outlines various types of colostomy pouches, including open-ended and close-ended pouches, one-piece and two-piece systems, and pre-cut versus cut-to-fit pouches. It provides instructions for changing pouches and irrigating a colostomy.
The document discusses colostomies, including their anatomy, indications for use, preoperative preparations, operative techniques, postoperative care, complications, and closure. A colostomy is a surgically created opening of the colon through the abdominal wall to divert fecal matter. It may be temporary or permanent depending on the underlying condition. Proper education and care are important for managing colostomies and improving patients' quality of life. Complications can include bleeding, prolapse, hernias, and skin irritation.
An intestinal stoma is an artificial opening in the abdominal wall that connects the intestinal tract to the outside of the body. There are different types of stomas including ileostomies, colostomies, and urostomies. Ileostomies divert small intestine contents and have a liquid effluent that is discharged continuously. Colostomies divert large intestine contents and have solid, intermittent effluent. Stomas can be temporary or permanent depending on the clinical situation and are constructed in different ways including as an end stoma or loop stoma. Proper stoma care and use of appliances is important for managing stomas.
- Intestinal stomas are surgically created openings of the small or large intestine onto the abdominal wall. There are three main types: colostomy, ileostomy, and loop stoma.
- Complications include prolapse, herniation, stenosis, dermatitis from effluent, and obstruction. Dietary advice focuses on reducing gas, bulk and odorous foods. Management involves properly attaching collection bags and monitoring for complications.
This document provides information about colostomies, including:
1. A colostomy is a stoma of the colon that diverts fecal matter and flatus by creating an opening between the colon and skin.
2. Indications for colostomy include both congenital conditions like Hirschsprung's disease and acquired conditions like intestinal obstruction, gangrenous bowel, or protecting a bowel anastomosis.
3. Colostomies can be classified temporally as temporary or permanent, anatomically by the portion of colon used, or constructionally as loop or divided depending on if the bowel is divided or intact.
An ostomy is a surgically created opening in the intestine that allows for waste to exit the body into an external bag. There are two main types - an ileostomy, which is created from the small intestine, and a colostomy, which is created from the large intestine. An ostomy may be temporary or permanent and is usually required due to conditions like cancer, IBD, or injury. Attaching the external bag securely is important to prevent complications. Diet and lifestyle adjustments are also needed after an ostomy is created.
This document discusses intestinal stomas, including definitions, types, indications, and routine care. It covers colostomies and ileostomies, which are surgically created openings of the small or large intestine onto the abdominal wall. Complications are also summarized, such as dermatological issues, bleeding, necrosis, retraction, hernias, and prolapse. The document provides overview on prevention, risk factors, signs, and management of various stoma-related complications.
This document discusses colostomy care and procedures. It defines a colostomy as an artificial opening in the large intestine brought to the surface of the abdomen. It then classifies colostomies as either temporary or permanent, and by stoma site or number/type. Common indications for a colostomy include colon cancer, Hirschsprung's disease, and ulcerative colitis. The purpose of colostomy care is to protect the skin, provide drainage, clean and regulate the bowel, and enable patient self-care. Required equipment includes supplies for changing appliances and bags, as well as accessories like filters, tape, soap, and gloves. Colostomy irrigation is defined as introducing a solution through the
This document discusses colostomies and ostomy care. It describes common medical conditions that may necessitate an ostomy, including imperforate anus, Hirschsprungs disease, inflammatory bowel disease, necrotizing enterocolitis, and spina bifida. It then focuses on ileostomies and colostomies, describing the differences and care involved. The document outlines various types of colostomy pouches, including open-ended and close-ended pouches, one-piece and two-piece systems, and pre-cut versus cut-to-fit pouches. It provides instructions for changing pouches and irrigating a colostomy.
The document discusses colostomies, including their anatomy, indications for use, preoperative preparations, operative techniques, postoperative care, complications, and closure. A colostomy is a surgically created opening of the colon through the abdominal wall to divert fecal matter. It may be temporary or permanent depending on the underlying condition. Proper education and care are important for managing colostomies and improving patients' quality of life. Complications can include bleeding, prolapse, hernias, and skin irritation.
An intestinal stoma is an artificial opening in the abdominal wall that connects the intestinal tract to the outside of the body. There are different types of stomas including ileostomies, colostomies, and urostomies. Ileostomies divert small intestine contents and have a liquid effluent that is discharged continuously. Colostomies divert large intestine contents and have solid, intermittent effluent. Stomas can be temporary or permanent depending on the clinical situation and are constructed in different ways including as an end stoma or loop stoma. Proper stoma care and use of appliances is important for managing stomas.
- Intestinal stomas are surgically created openings of the small or large intestine onto the abdominal wall. There are three main types: colostomy, ileostomy, and loop stoma.
- Complications include prolapse, herniation, stenosis, dermatitis from effluent, and obstruction. Dietary advice focuses on reducing gas, bulk and odorous foods. Management involves properly attaching collection bags and monitoring for complications.
COLONOSCOPY- A PICTORIAL OVERVIEW
• Dear viewers,
• Greetings from “Surgical Educator”
• This week I have uploaded a video on Colonoscopy- the Lower GI Endoscopy.
• In this episode, I showed only the colonoscopic features of common pathologies in colon and rectum.
• I restricted my talk to the essential minimum that an undergraduate medical student must know about the Colonoscopy.
• I discussed about the diagnostic and therapeutic procedures you can do with the Colonoscopy.
• I hope it would be interesting and very useful to all my viewers.
• You can access this video in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
Surgical drains, tube, catheters and central linesAhmed Almumtin
This document provides an overview of different types of surgical drains, tubes, and lines, including their purposes, uses, and potential complications. It discusses open and closed drainage systems, as well as active and passive drains. Specific drains covered include Jackson-Pratt drains, Penrose drains, negative pressure wound therapy, chest tubes, T-tubes, and Redivac drains. Guidelines are provided for drain placement, management, and removal. Complications related to poor drain selection, placement, and postoperative care are also summarized.
This document discusses stoma care for surgeons. It defines a stoma and the main types including colostomy, ileostomy, and urostomy. It covers preparing and counseling patients for stoma surgery, postoperative stoma care including complications, and general stoma care advice. Stoma appliances are also described including types like closed, drainable, one-piece, and two-piece systems. Optimal stoma site selection and factors in stoma care like diet, exercise, and sexual activity are also summarized.
Loop ileostomy or loop colostomy can be used to divert fecal streams and protect colorectal anastomoses based on indications from various diseases and procedures. Complications occur in 21-70% of cases, relating to the stoma, peristomal skin, or systemic issues. Guidelines recommend techniques to decrease complications like laparoscopy, protruding stomas, and mesh reinforcement. While some studies found ileostomy had fewer hernias and prolapses, meta-analyses show no clear preference between ileostomy and colostomy. Alternative options like ghost ileostomy or transanal decompression tubes may help avoid stomas in some cases.
This document provides information about stomas, including definitions and types. It discusses colostomies and ileostomies, which are artificial openings of the colon or ileum onto the abdominal surface. Characteristics and indications for stomas are described. The document outlines preoperative management and nursing care before and after stoma surgery. Potential postoperative complications are listed. Information is provided about appliances and how to change a stoma bag.
A stoma is a surgically created opening that allows stool or urine to exit the body. There are three main types - colostomy, ileostomy, and urostomy. A colostomy diverts feces, while an ileostomy diverts intestinal contents which are usually liquid. A urostomy diverts urine. Complications can include prolapse, retraction, hernia, and skin irritation. When siting a stoma, it is important to choose a well-vascularized area that is away from skin folds, scars, and bony prominences to help prevent these complications.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is commonly performed to treat conditions like cancer, bowel obstructions, or injuries. After surgery, patients require care of the stoma including regularly emptying and changing ostomy pouches. A healthy diet and lifestyle can help manage symptoms and complications after having a colostomy.
Stoma complications & its managementDr Harsh Shah
This document discusses complications that can occur with stomas. It defines stomas and provides the incidence of early and late complications. Early complications include skin irritation, stoma necrosis, bowel obstruction, ileostomy diarrhea, and mucocutaneous separation. Late complications include stoma stenosis, prolapse, parastomal hernia, and fistula. For each complication, the document discusses causes, clinical features, and management approaches. It provides details on evaluating and treating various early and late stoma complications.
Urinary diversion procedures are performed to divert urine from the bladder to a new exit site, usually through a surgically created opening (stoma) in the skin.
These procedures are primarily performed when a bladder tumor necessitates removal of the entire bladder (cystectomy).
Urinary diversion has also been used in managing pelvic malignancy, birth defects, strictures, trauma to ureters and urethra, neurogenic bladder, chronic infection causing severe ureteral and renal damage, and intractable interstitial cystitis and as a last resort in managing incontinence.
There are two categories of urinary diversion:
1. Cutaneous urinary diversion : in which urine drains through an opening created in the abdominal wall and skin.
2. Continent urinary diversion : in which a portion of the intestine is used to create a new reservoir for urine.
This document discusses hemorrhoidectomy, which is the surgical excision of hemorrhoids. It defines hemorrhoidectomy and lists its indications. The types of hemorrhoidectomy procedures are open, closed, and stapled. Preoperative preparation includes a high fiber diet, stool softeners, and antibiotics. The procedure involves excising hemorrhoids using spinal or general anesthesia and leaving tissue bridges between excised areas. Post-operative management includes analgesia, laxatives, and sitz baths. Complications can include bleeding, urinary retention, impaction, stenosis, fissures, tags, recurrence, and incontinence.
A laparotomy is a surgical procedure involving an incision through the abdominal wall to access the abdominal cavity. It can be performed for both diagnostic and therapeutic purposes when there is a need for surgery but no definitive pre-operative diagnosis. The key steps include pre-operative preparation, gaining surgical access, systematically exploring the abdominal cavity including solid organs and intestines, performing any necessary procedures, and closing the abdominal wall. Complications can include infection, adhesions, hernias and more, so thorough exploration and drainage if needed is important.
This document provides information about cystoscopy and urethroscopy procedures. It defines cystoscopy as an examination of the inside of the bladder using a cystoscope, which is a thin instrument with a lens and light. Urethroscopy examines the inside of the upper urinary tract including the ureters and renal pelvis using a ureteroscope. Cystoscopy and urethroscopy can be performed rigidly or flexibly to evaluate issues like blood in the urine, infections, or abnormalities. The document outlines the procedures and anatomy of the urinary tract and discusses common reasons for requiring cystoscopy or urethroscopy like stones, tumors, or blockages.
This document provides an overview of inguinal hernias. It defines a hernia as the protrusion of an organ through a weakness in the muscle wall. It then discusses the epidemiology, types, anatomy, etiology, pathogenesis, signs and symptoms, diagnosis, treatment and complications of inguinal hernias. The treatment options covered are herniotomy, herniorrhaphy, and laparoscopic repair techniques like the Lichtenstein method. The prognosis is typically good, though there is a small risk of recurrence.
This document provides information about colostomy care, including:
1. A colostomy is a surgical procedure that diverts the colon through an opening in the abdominal wall to remove a damaged part. Proper care of the stoma, pouch, and surrounding skin is needed to prevent infection and promote comfort.
2. Indications for a colostomy include birth defects, inflammatory bowel disease, injuries, blockages, cancers, and wounds.
3. The location of the stoma depends on the type of colostomy, which can be ascending, transverse, descending, or sigmoid. Proper assessment of the stoma and skin is important to monitor health.
This document describes the procedure for a right hemicolectomy. It involves making a midline abdominal incision, mobilizing the terminal ileum and cecum, ligating and dividing the ileocolic, right colic, and middle colic vessels, removing the ascending colon and portions of the ileum and transverse colon. An end-to-side anastomosis is then performed between the ileum and transverse colon using interrupted sutures in two layers to reconnect the bowel.
An exploratory laparotomy is a surgical procedure where the abdomen is opened to examine the internal organs. It is performed under general anesthesia through an upper midline incision. Indications include trauma, infections, malignancy, complications of other procedures, and removal of foreign bodies. During the procedure, the surgeon examines the abdominal organs and treats any issues found. Potential complications include ileus, infection, hernia, and adhesive obstruction.
This document provides information on surgical drains, including:
- Surgical drains are tubes used to remove fluids like pus, blood or serum from surgical sites or wounds.
- Drains are classified as open or closed systems and can be active, using suction, or passive, relying on gravity. Common types include Jackson-Pratt, chest, and nasogastric tubes.
- Drains must be properly inserted, secured, and monitored for drainage volume and signs of infection. They are usually removed once drainage decreases to less than 25ml/day to avoid complications like infection or blockage.
The document discusses stoma care, including definitions, indications for ostomy surgery, types of stomas, and how to care for a stoma. Some key points include:
- A stoma is a surgically created opening that allows stool or urine to exit the body. Common reasons for ostomy surgery in children include birth defects and inflammatory bowel disease.
- There are three main types of stomas - colostomy, ileostomy, and urostomy - depending on where in the digestive or urinary system the opening is created.
- Proper stoma care involves using pouches and barriers to collect waste, changing pouches regularly, and techniques like irrigation for some colostomies. Managing
This document provides an overview of colostomies, including:
- A definition of a colostomy as surgically bringing part of the large intestine through the abdominal wall.
- Classifications of colostomies by purpose (temporary or permanent), function (decompressing or defunctioning), site, and type.
- Indications for colostomies including congenital diseases like Hirschsprung's and acquired diseases like cancer, trauma, or obstruction.
- Details on forming, caring for, and closing a colostomy, as well as potential complications.
- The document is intended as a reference for medical professionals on colostomies.
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
COLONOSCOPY- A PICTORIAL OVERVIEW
• Dear viewers,
• Greetings from “Surgical Educator”
• This week I have uploaded a video on Colonoscopy- the Lower GI Endoscopy.
• In this episode, I showed only the colonoscopic features of common pathologies in colon and rectum.
• I restricted my talk to the essential minimum that an undergraduate medical student must know about the Colonoscopy.
• I discussed about the diagnostic and therapeutic procedures you can do with the Colonoscopy.
• I hope it would be interesting and very useful to all my viewers.
• You can access this video in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
Surgical drains, tube, catheters and central linesAhmed Almumtin
This document provides an overview of different types of surgical drains, tubes, and lines, including their purposes, uses, and potential complications. It discusses open and closed drainage systems, as well as active and passive drains. Specific drains covered include Jackson-Pratt drains, Penrose drains, negative pressure wound therapy, chest tubes, T-tubes, and Redivac drains. Guidelines are provided for drain placement, management, and removal. Complications related to poor drain selection, placement, and postoperative care are also summarized.
This document discusses stoma care for surgeons. It defines a stoma and the main types including colostomy, ileostomy, and urostomy. It covers preparing and counseling patients for stoma surgery, postoperative stoma care including complications, and general stoma care advice. Stoma appliances are also described including types like closed, drainable, one-piece, and two-piece systems. Optimal stoma site selection and factors in stoma care like diet, exercise, and sexual activity are also summarized.
Loop ileostomy or loop colostomy can be used to divert fecal streams and protect colorectal anastomoses based on indications from various diseases and procedures. Complications occur in 21-70% of cases, relating to the stoma, peristomal skin, or systemic issues. Guidelines recommend techniques to decrease complications like laparoscopy, protruding stomas, and mesh reinforcement. While some studies found ileostomy had fewer hernias and prolapses, meta-analyses show no clear preference between ileostomy and colostomy. Alternative options like ghost ileostomy or transanal decompression tubes may help avoid stomas in some cases.
This document provides information about stomas, including definitions and types. It discusses colostomies and ileostomies, which are artificial openings of the colon or ileum onto the abdominal surface. Characteristics and indications for stomas are described. The document outlines preoperative management and nursing care before and after stoma surgery. Potential postoperative complications are listed. Information is provided about appliances and how to change a stoma bag.
A stoma is a surgically created opening that allows stool or urine to exit the body. There are three main types - colostomy, ileostomy, and urostomy. A colostomy diverts feces, while an ileostomy diverts intestinal contents which are usually liquid. A urostomy diverts urine. Complications can include prolapse, retraction, hernia, and skin irritation. When siting a stoma, it is important to choose a well-vascularized area that is away from skin folds, scars, and bony prominences to help prevent these complications.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is commonly performed to treat conditions like cancer, bowel obstructions, or injuries. After surgery, patients require care of the stoma including regularly emptying and changing ostomy pouches. A healthy diet and lifestyle can help manage symptoms and complications after having a colostomy.
Stoma complications & its managementDr Harsh Shah
This document discusses complications that can occur with stomas. It defines stomas and provides the incidence of early and late complications. Early complications include skin irritation, stoma necrosis, bowel obstruction, ileostomy diarrhea, and mucocutaneous separation. Late complications include stoma stenosis, prolapse, parastomal hernia, and fistula. For each complication, the document discusses causes, clinical features, and management approaches. It provides details on evaluating and treating various early and late stoma complications.
Urinary diversion procedures are performed to divert urine from the bladder to a new exit site, usually through a surgically created opening (stoma) in the skin.
These procedures are primarily performed when a bladder tumor necessitates removal of the entire bladder (cystectomy).
Urinary diversion has also been used in managing pelvic malignancy, birth defects, strictures, trauma to ureters and urethra, neurogenic bladder, chronic infection causing severe ureteral and renal damage, and intractable interstitial cystitis and as a last resort in managing incontinence.
There are two categories of urinary diversion:
1. Cutaneous urinary diversion : in which urine drains through an opening created in the abdominal wall and skin.
2. Continent urinary diversion : in which a portion of the intestine is used to create a new reservoir for urine.
This document discusses hemorrhoidectomy, which is the surgical excision of hemorrhoids. It defines hemorrhoidectomy and lists its indications. The types of hemorrhoidectomy procedures are open, closed, and stapled. Preoperative preparation includes a high fiber diet, stool softeners, and antibiotics. The procedure involves excising hemorrhoids using spinal or general anesthesia and leaving tissue bridges between excised areas. Post-operative management includes analgesia, laxatives, and sitz baths. Complications can include bleeding, urinary retention, impaction, stenosis, fissures, tags, recurrence, and incontinence.
A laparotomy is a surgical procedure involving an incision through the abdominal wall to access the abdominal cavity. It can be performed for both diagnostic and therapeutic purposes when there is a need for surgery but no definitive pre-operative diagnosis. The key steps include pre-operative preparation, gaining surgical access, systematically exploring the abdominal cavity including solid organs and intestines, performing any necessary procedures, and closing the abdominal wall. Complications can include infection, adhesions, hernias and more, so thorough exploration and drainage if needed is important.
This document provides information about cystoscopy and urethroscopy procedures. It defines cystoscopy as an examination of the inside of the bladder using a cystoscope, which is a thin instrument with a lens and light. Urethroscopy examines the inside of the upper urinary tract including the ureters and renal pelvis using a ureteroscope. Cystoscopy and urethroscopy can be performed rigidly or flexibly to evaluate issues like blood in the urine, infections, or abnormalities. The document outlines the procedures and anatomy of the urinary tract and discusses common reasons for requiring cystoscopy or urethroscopy like stones, tumors, or blockages.
This document provides an overview of inguinal hernias. It defines a hernia as the protrusion of an organ through a weakness in the muscle wall. It then discusses the epidemiology, types, anatomy, etiology, pathogenesis, signs and symptoms, diagnosis, treatment and complications of inguinal hernias. The treatment options covered are herniotomy, herniorrhaphy, and laparoscopic repair techniques like the Lichtenstein method. The prognosis is typically good, though there is a small risk of recurrence.
This document provides information about colostomy care, including:
1. A colostomy is a surgical procedure that diverts the colon through an opening in the abdominal wall to remove a damaged part. Proper care of the stoma, pouch, and surrounding skin is needed to prevent infection and promote comfort.
2. Indications for a colostomy include birth defects, inflammatory bowel disease, injuries, blockages, cancers, and wounds.
3. The location of the stoma depends on the type of colostomy, which can be ascending, transverse, descending, or sigmoid. Proper assessment of the stoma and skin is important to monitor health.
This document describes the procedure for a right hemicolectomy. It involves making a midline abdominal incision, mobilizing the terminal ileum and cecum, ligating and dividing the ileocolic, right colic, and middle colic vessels, removing the ascending colon and portions of the ileum and transverse colon. An end-to-side anastomosis is then performed between the ileum and transverse colon using interrupted sutures in two layers to reconnect the bowel.
An exploratory laparotomy is a surgical procedure where the abdomen is opened to examine the internal organs. It is performed under general anesthesia through an upper midline incision. Indications include trauma, infections, malignancy, complications of other procedures, and removal of foreign bodies. During the procedure, the surgeon examines the abdominal organs and treats any issues found. Potential complications include ileus, infection, hernia, and adhesive obstruction.
This document provides information on surgical drains, including:
- Surgical drains are tubes used to remove fluids like pus, blood or serum from surgical sites or wounds.
- Drains are classified as open or closed systems and can be active, using suction, or passive, relying on gravity. Common types include Jackson-Pratt, chest, and nasogastric tubes.
- Drains must be properly inserted, secured, and monitored for drainage volume and signs of infection. They are usually removed once drainage decreases to less than 25ml/day to avoid complications like infection or blockage.
The document discusses stoma care, including definitions, indications for ostomy surgery, types of stomas, and how to care for a stoma. Some key points include:
- A stoma is a surgically created opening that allows stool or urine to exit the body. Common reasons for ostomy surgery in children include birth defects and inflammatory bowel disease.
- There are three main types of stomas - colostomy, ileostomy, and urostomy - depending on where in the digestive or urinary system the opening is created.
- Proper stoma care involves using pouches and barriers to collect waste, changing pouches regularly, and techniques like irrigation for some colostomies. Managing
This document provides an overview of colostomies, including:
- A definition of a colostomy as surgically bringing part of the large intestine through the abdominal wall.
- Classifications of colostomies by purpose (temporary or permanent), function (decompressing or defunctioning), site, and type.
- Indications for colostomies including congenital diseases like Hirschsprung's and acquired diseases like cancer, trauma, or obstruction.
- Details on forming, caring for, and closing a colostomy, as well as potential complications.
- The document is intended as a reference for medical professionals on colostomies.
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
This document provides information about colostomies, including:
- A colostomy is a surgically created opening in the abdomen that connects the colon to the outside of the body. It can be temporary or permanent.
- Indications for a colostomy include birth defects, infections, inflammatory bowel disease, injuries, blockages, and cancers of the colon or rectum.
- There are different types of colostomies including loop, end, and double barrel.
- Post-operative nursing care includes skin care, psychosocial support, nutrition, patient education on colostomy management, and monitoring for potential complications.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be permanent or temporary and is often performed to treat disorders of the large intestine like cancer or injury. There are four main types of colostomies named after the portion of the large intestine where the stoma is located. Aftercare for a colostomy involves monitoring the surgical site, using a colostomy pouching system, and gradually resuming a regular diet while avoiding certain gassy or odorous foods.
This document outlines the presentation, causes, diagnosis, treatment, and nursing care of volvulus, which is the twisting of a loop of intestine that cuts off blood flow. It most commonly affects the sigmoid colon. Key points include that volvulus can be acute, sub-acute, or chronic; surgical intervention is usually needed to untwist the intestine; and nursing care involves pain management, fluid replacement, monitoring for complications, and educating patients and families.
Understanding the Colectomy Procedure.pdfMeghaSingh194
A colectomy is a major surgical surgery that calls for a significant amount of time spent both getting ready for the operation and recovering afterward. Let's explore more: https://www.southlakegeneralsurgery.com/understanding-the-colectomy-procedure/
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is often needed to treat conditions like cancer, bowel obstructions, or injuries. Potential complications include bleeding, infection, or issues with the stoma like necrosis, retraction, or prolapse. Proper care of the stoma and emptying of the colostomy bag is important for recovery. A healthy diet and lifestyle can be maintained after surgery.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is often needed to treat conditions like cancer, bowel obstructions, or injuries. Potential complications include bleeding, infection, or issues with the stoma like necrosis, retraction, or prolapse. Proper care of the stoma and emptying of the colostomy bag is important for recovery. A healthy diet and lifestyle can be maintained after surgery.
The document discusses various endoscopic procedures including colonoscopy, hernioplasty, and gastric lavage. It provides details on how each procedure is performed, what conditions they are used to treat, and potential risks involved. Choledocholithotripsy is highlighted as a non-surgical alternative to cholecystectomy for treating gallstones using shock waves to shatter stones in the gallbladder.
This document provides information on various types of stoma diversions including urinary and fecal diversions. It describes the reasons for diversions, types of urinary diversions including incontinent diversions like ileal conduits and continent diversions like Kock pouches. It also describes types of fecal diversions including incontinent diversions like colostomies and continent diversions like ileoanal reservoirs. Postoperative nursing care focuses on assessing the stoma, protecting the skin, and helping the patient adapt psychologically.
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#Nursing Care.
This topic is Related to the nursing care of colostomy patient. This slide includes the nursing diagnosis also. Share with other nursing students.
3. Caring for the patient undergoing ostomy surgery.pptxchamodyaprashani
The document discusses caring for patients undergoing fecal ostomy surgery, including describing the two main types of fecal ostomies (colostomy and ileostomy), characteristics of stomas, pre-operative and post-operative nursing care of patients, potential complications, and education on ostomy management and skin care. Nursing interventions focus on managing nutrition, alleviating anxiety, maintaining skin integrity, and promoting a positive body image and self-care skills through education and support.
Colostomy power point is very important for studentstembotisa26
This topic will help health worker to know what colostomy is and it will help them to have knowledge on the management of the patient with this condition
Management of enterocutaneous fistulas involves several phases:
1) Recognition and stabilization including resuscitation, controlling sepsis and drainage, nutrition support, and skin care.
2) Investigation using fistulograms and CT scans to define the fistula anatomy and underlying pathology.
3) Decision on management which depends on factors predicting spontaneous closure like output, nutrition status and bowel health.
4) Definitive surgery including bowel resection and anastomosis if needed, otherwise a staged approach with bypass.
5) Post-surgical recovery focusing on preventing recurrent fistula and hernia.
This document discusses bowel elimination structures and processes. It describes how peristaltic waves move feces through the colon and into the rectum, triggering a need to defecate when sensory nerves are stimulated. Voluntary relaxation of sphincter muscles allows expulsion of feces, assisted by abdominal and diaphragm contractions in a sitting position. Factors like lifestyle, culture, age, and medical issues can affect bowel elimination.
A colostomy is a surgical opening in the colon that is brought through the abdominal wall to allow stool to exit the body. It can be temporary to allow the colon to heal after surgery or permanent. Nurses provide pre- and post-operative care for patients with colostomies, which involves educating them on stoma care like changing pouches and monitoring for issues like irritation or infection. Proper nursing care and teaching patients self-care techniques helps them adjust to life after colostomy surgery.
1. An enterocutaneous fistula is an abnormal connection between the gastrointestinal tract and the skin that usually results from surgery or trauma. The ileum is the most common site of origin.
2. Factors that favor spontaneous closure include small defects, jejunal or colonic origins, and continuity of the gastrointestinal tract. Factors that discourage closure are the presence of inflammation, infection, obstruction, or malignancy.
3. Treatment involves stabilization, controlling sepsis, defining the anatomy, and planning definitive therapy, which is usually surgery to resect the involved segment after 6-12 weeks of management.
The document discusses the care of patients with ostomies, including defining an ostomy as a surgically created opening in the abdomen that brings part of the bowel to the outside of the body. It describes different types of ostomies like colostomies and the purposes and procedures for colostomy care, which involves changing disposable pouches to collect waste and caring for the stoma and surrounding skin. The document also provides home care considerations and resources for patients with ostomies.
This document discusses different types of scrotal cystic masses including hydroceles, hernias, and other conditions. It describes how to differentiate between a hydrocele and inguinal hernia by palpating for the cord, checking for translucency and fluctuation of the mass, and determining if the testis is palpable or there is a cough impulse. The document also notes that fluid aspirated from different types of cystic masses will be different colors - a cord hydrocele will be straw colored, a spermatocele will be milky or grey, and an epididymis cyst will be clear. Treatment options mentioned include hydrocelectomy, aspiration with a sclerosing agent
This document provides an overview of breast cancer including its definition, epidemiology, risk factors, pathophysiology, clinical presentation, workup, staging, and management. Some key points:
- Breast cancer arises from the epithelial lining of the breast and is the most common cancer in women worldwide.
- Risk factors include family history, certain genetic mutations, reproductive factors, and density. Symptoms may include a breast lump, nipple discharge, or skin/nipple changes.
- Diagnostic workup involves imaging like mammography and biopsy. Staging uses the TNM system and determines tumor size, lymph node involvement, and metastasis. Treatment is based on staging.
This document describes the abdominal palpation technique known as Leopold's maneuver. It is used to determine fetal position and presentation. The 4-step process involves palpating the fundus, back, lower abdomen, and sides to identify the fetal lie, presentation, attitude, and degree of engagement. The possible presentations are vertex, brow, face, breech or shoulder. The attitude can be flexed, deflexed or extended. Engagement is measured by how many fifths of the head are below the pelvic brim.
This document provides information on congenital heart disease, including definitions, classifications, and details on specific conditions. It defines congenital heart disease and notes its prevalence of about 1% of live births. It classifies heart defects into left-to-right shunt lesions, right to left shunt lesions, and obstructive lesions. Details are given on specific conditions including atrial septal defect, ventricular septal defect, and patent ductus arteriosus. For each, the document describes hemodynamics, clinical findings, diagnosis, and treatment. Echocardiography is highlighted as the primary diagnostic tool for congenital heart disease.
Hypertensive disorders in pregnancy include pregnancy-induced hypertension, chronic hypertension, and pregnancy-aggravated hypertension. Pregnancy-induced hypertension involves new hypertension after 20 weeks of gestation and can lead to preeclampsia or eclampsia. HELLP syndrome is a severe form of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelets. While the exact causes are unknown, risk factors include nulliparity, chronic hypertension, and family history. Treatment involves controlling blood pressure, preventing seizures, and delivering the baby to resolve the condition.
This document defines gastrointestinal fistulas and outlines their classification, causes, symptoms, treatment approach, and complications. It describes how fistulas are abnormal connections between the GI tract and other organs or skin. Treatment is organized into four phases - stabilization, investigation, conservative management, and definitive surgery. The goal of stabilization is resuscitation, sepsis control, nutrition, and drainage management. Conservative treatment aims to allow spontaneous closure, while surgery is indicated for failed non-operative treatment or complex fistulas. Prognosis depends on factors like etiology, nutrition status, and sepsis control.
This document discusses the management of ulcers. It defines an ulcer as a break in the epithelial covering of the skin or mucous membrane. Ulcers are classified clinically as spreading, healing, or callous ulcers, and pathologically as specific or non-specific. The pathophysiology of an ulcer progresses through extension, transition, and repair phases. Clinical presentation involves examining the ulcer's characteristics, surrounding skin, and discharging material. Diagnosis involves laboratory tests, imaging, and biopsy. Treatment aims to address the underlying cause and may involve dressings, skin grafting, or flaps.
This document discusses abdominal wall hernias. It defines hernias as the protrusion of a viscus or part of it through a defect in the abdominal wall. It describes the surgical anatomy of hernias and classifies them based on etiology, anatomy, and clinical presentation. Specific hernias discussed in detail include inguinal hernias, femoral hernias, and umbilical hernias. Diagnosis and management approaches are provided for each type of hernia.
This document provides an overview of intestinal obstruction, including:
- Definitions, classifications, etiologies, pathophysiology, clinical presentations, workup, and treatment of intestinal obstruction.
- Intestinal obstruction can be mechanical/dynamic from intraluminal, intramural/intrinsic, or extramural/extrinsic causes, or functional/adynamic from paralytic ileus, pseudo-obstruction, or other causes.
- Clinical features depend on location and severity of obstruction but commonly include abdominal pain, vomiting, distension, and constipation. Workup involves laboratory tests and physical exam to evaluate for complications like ischemia.
Burn injuries can result from heat, cold, chemicals, electricity or radiation. They cause skin and tissue damage through coagulation necrosis. Globally, about 1% of the population sustains burns annually. In the US, over 2 million burn injuries are reported each year. Burns significantly increase morbidity and mortality. Younger children commonly experience scalds while flames cause most adult burns. Burn depth, extent, mechanism and presence of inhalation injury are important factors in classification and prognosis. Both local and systemic inflammatory responses can result from severe burns.
This document discusses malaria, a disease caused by Plasmodium parasites and transmitted via mosquito bites. It covers the life cycle and pathophysiology of the malaria parasite, clinical presentation of symptoms, management and treatment approaches, prevention methods, and ongoing challenges. The key points are:
1. Malaria remains a major public health problem in tropical regions, with over 50 million cases globally in 2016. The most severe form is caused by P. falciparum.
2. The parasite has a liver stage and blood stage, infecting hepatocytes and red blood cells. It evades the immune system by sequestering in blood vessels.
3. Symptoms include fever, chills, headaches and
This document discusses biopsy principles and abdominal tumors in veterinary medicine. It provides guidelines for obtaining biopsy samples, including using the proper technique to procure enough tissue for an accurate diagnosis without increasing the risk of metastasis. Needle biopsy, incisional biopsy, and excisional biopsy are described as common methods. The role of the pathologist in interpreting biopsy results and potential sources of error are also outlined. For abdominal tumors, the document recommends evaluations like radiographs and ultrasound prior to exploration. It states that solitary masses should be explored for diagnosis and possible treatment, while diffuse disease is rarely helped by surgery alone. Factors like tumor stage, site and grade will impact therapy and prognosis.
Cancer of the uterine cervix is a major health problem in Tanzania, being the most common cancer in women. It is caused by certain strains of the human papillomavirus (HPV). Risk factors include early onset of sexual activity, multiple partners, and smoking. Symptoms include abnormal bleeding and discharge. Diagnosis involves Pap smears, biopsies, and clinical exams. Staging looks at tumor size and spread. Treatment options include surgery, radiation, chemotherapy, and palliative care. Screening programs and the HPV vaccine can help prevent cervical cancer if widely implemented.
This document discusses endometrial carcinoma, a cancer that arises from the endometrium or lining of the uterus. It most commonly occurs after menopause and signs include abnormal vaginal bleeding or pain during urination or sex. Risk factors include excessive estrogen exposure, diabetes, and nulliparity. Screening is difficult but abnormal uterine thickness on ultrasound may indicate need for further testing. Diagnosis involves endometrial biopsy or curettage. Treatment is surgical removal of the uterus and ovaries, with chemotherapy sometimes also used. Prognosis depends on stage, with 5-year survival rates ranging from 85% for stage I to 22% for stage IV.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Pharmacology of 5-hydroxytryptamine and Antagonist
COLOSTOMY.ppt
1. Dr Phillipo Leo Chalya MD, M.Med (Surg)
Senior Lecturer – Department of Surgery
CUHAS-Bugando
COLOSTOMY
2. Leaning objectives
Definition
Indications
Classifications
Colostomy formation
Colostomy care
Colostomy closure
Complications of colostomy and its
closure
Conclusion
3. DEFINITION
A colostomy is a surgical procedure that
brings a portion of the large intestine through
the anterior abdominal wall to divert faeces
and flatus to the exterior, where it can be
collected in an external appliance (colostomy
bag)
14. CLASSIFICATION
According to the purpose
According to the function
According to the site/location
According to the type of colostomy
According to the nature of operation
15. According to the purpose
Temporary colostomy
Permanent colostomy
16. Temporary colostomy
Temporary colostomies are created to divert
stool from injured or diseased portions of the
large intestine, allowing rest and healing and
later closed to maintain the bowel continuity
Commonly loop or double barrel colostomies
17. Permanent colostomy
Permanent colostomies are performed when the distal
bowel (at the farthest distance) must be removed or is
blocked and inoperable
Permanent colostomy are usually formed after
resection of the rectum for a carcinoma by the
abdominoperineal technique [APR]
They are usually end colostomy
18. According to the function
Decompressing colostomy
Defunctioning /diverting colostomy
19. Decompressing colostomy
Intended to decompress the colon
It does not completely defunction the bowel as
some faeces can travel into the distal loop
It is inadequate in conditions in which
defunctioning is essential
Example of this is a loop colostomy
20. Defunctioning /diverting colostomy
Intended to defunction or to divert the colon i.e.
to prevent faecal material traveling into the
distal segment
In this case the bowel is transected and the
two ends [proximal and distal ends] need to be
separated
Include end , spectacle or double-barrel
colostomy
21. According to the site/location
Transverse
colostomy
Sigmoid colostomy
Caecostomy
22. According to the type
Loop colostomy
Double – barrel colostomy
End colostomy
Spectacle colostomy
23. Loop colostomy
This colostomy is created
by bringing a loop of bowel
through an incision in the
abdominal wall
A loop colostomy is made
by bringing a loop of colon
to the surface, where it is
held in place by a plastic
bridge passed through the
mesentery
24. Double – barrel colostomy
The bowel is transected
and the two ends are
brought together through
one incision
The proximal end is the
functional end that is
connected to the upper GI
and will drain stool; the
distal stoma, connected to
the rectum and also called
a mucous fistula, drains
small amounts of mucus
material
25. End colostomy
The functioning
proximal end of the
intestine is brought out
onto the surface of the
abdomen, forming the
stoma (colostomy)
The distal portion of
bowel (now connected
only to the rectum) may
be removed, or sutured
closed and left in the
abdomen
26. Spectacles colostomy
The proximal and distal limbs are
separated by small bridge of skin
The two limbs are opened
through a separate skin incision
With the introduction of end
colostomy with Hatmann
procedure, spectacles colostomy
is no longer performed
27. According to the nature of operation
Emergency colostomy
Elective colostomy
29. Principles of colostomy formation
The colostomy site should be selected to avoid fat
folds, scars, umbilicus and bony prominences
The colostomy should be brought through a separate
skin incision and not through a laparotomy incision
Tension on the mesentery should be avoided during
construction of a colostomy i.e. the bowel should be
mobile enough to be brought through the abdominal
wall
30. Pre-operative care
Colostomies are created in both elective and
emergency settings
Pre-operative care in involves:-
Counseling
Correction of intercurent infections, anemia and other co-
morbid conditions
Bowel preparation
Pre-anesthetic visit
Signing of a written informed consent
Enterostomal therapist visit
31. Counseling
Colostomy is a frightening procedure and exposes the
patient and her/his family to psychosocial trauma
Adequate counseling should be part and parcel of the entire
management strategy to enable the patient and his/her
family to cope with the stress and to adjust their life styles
A physician, enterostomal therapist, or nurse specialist
should counsel the patient undergoing elective colostomy
as well as their families
This psychological preparation reduces their anxiety and
makes postoperative management easier
The patient should be counseled properly on how to live
with a colostomy and how to take care of it
32. Correction of associated disease conditions
Intercurent infections [e.g. chest infections,
diarrhoea], anemia and other pre-existing
conditions should be controlled before surgery
33. Bowel preparation
Preoperative bowel preparation is important to avoid
colostomy-related complications
This include:-
Mechanical bowel preparation
Enema
Nasogastric tube on the day of operation or intraoperatively to
remove gastric secretions and prevent nausea and vomiting
Dietary management
Low residue diet for several days prior to surgery
A liquid diet may be ordered for at least the day before surgery,
with nothing by mouth after midnight
Pharmacological management
Oral anti-infectives (neomycin, erythromycin, or kanamycin
sulfate) may be ordered to decrease bacteria in the intestine
and help prevent postoperative infection
34. Pre-anesthetic visit
This should be done to be able to assess the
patient’s general condition and fitness for
surgery and anesthesia
35. Written informed consent
As with any surgical procedure, the patient
will be required to sign a consent form after
the procedure is explained thoroughly
36. Enterostomal therapist visit
If possible, the patient should visit an enterostomal
therapist, who will mark an appropriate place on the
abdomen for the stoma and offer preoperative
education on colostomy management
38. Post-operative care
Like in any major surgery postoperative care for the patient
with a new colostomy, involves:-
Fluids and electrolytes are infused intravenously until the
patient's diet can gradually be resumed, beginning with liquids
[usually up to 72 hrs]
The nasogastric tube will remain in place, until bowel activity
resumes
For the first 24–48 hours after surgery, the colostomy will drain
bloody mucus
Analgesics to relieve pain
Antibiotics given parenterally
Monitoring of blood pressure, pulse, respirations, and
temperature [vital signs]
A colostomy pouch will generally have been placed on the
patient's abdomen around the stoma during surgery
39. COLOSTOMY CARE
Psychological care
Mechanical care
Dietary care
Gas and odor care
Peristomal skin care
Pharmacological care
40. Psychological care
Counseling should continue during treatment
and follow up to enable the patient to cope to
their life style
Often, an enterostomal therapist will visit the
patient in the hospital or at home after
discharge to provide counseling and to help
the patient with stoma care
41. Mechanical care
Use of colostomy bags [pouches]
Colostomy irrigation [i.e. putting a fluid into the stoma
to empty the bowel]also called colostomy enema
42. Dietary care
Dietary counseling is necessary for the patient to
maintain normal bowel function and to avoid
constipation, impaction, and other discomforts
Need to avoid foods that cause gas and odor e.g.
fish, onions, garlic, broccoli, asparagus, and cabbage
produce odor
43. Gas and odor care
Limit foods such as broccoli, cabbage,onions, fish, and
garlic in diet to help reduce odor
Each time you empty your pouch, carefully clean the
opening of the pouch, both inside and outside, with
toilet paper
Rinse your pouch one or two times daily after you
empty it
Add deodorant (such as Super Banish or Nullo) to your
pouch.
Use air deodorizers in your bathroom
44. Care of peristomal skin
Local irritation, skin excoriation, and yeast infections can
be treated with appropriate topical medication and skin
care
Protect skin from effluent using:-
Wafers eg Duoderm, Coloplast
Pastes eg Karaya, Softpaste
Lotions eg Cavilon,Dansac- use as spray or spread
Powders e.g. Orahesive- removes fluid from moist skin
Stoma bags
45. Pharmacological care
Once the colostomy has been established
no pharmacological treatment is required
Pharmacological care is reserved in case of
complications e.g. colostomy diarrhoea,
wound infections, constipation etc
46. COLOSTOMY CLOSURE
Prerequisites of colostomy closure
Timing of colostomy closure
Preoperative preparation
Types of colostomy closure
Post operative care
47. Prerequisites of colostomy closure
The following must be taken into account before
closing a colostomy:-
The original reason for the colostomy
Whether the patient is able to undergo more surgery
Patient’s general condition
The presence of stoma-related complications
Colostomy closure should be performed when the
patient has recovered from original operation, his
general condition is good and his colostomy wound is
healthy
48. Timing of colostomy closure
Timing of colostomy closure depends on factors such
as:-
the underlying disease
the general medical condition of the patient
the presence of colostomy-related complications
The state of the colostomy wound
Understanding the anatomy prior to colostomy closure
is crucial
Colostomy closure usually done in 2-6 weeks when
the colostomy wound is healthy and the patient has
recovered from his original operation
49. Preoperative preparation
The patient should be prepared as for any other major
surgery
The general condition of the patient and his colostomy
wound should be assessed for fitness to surgery
Enema to his proximal and distal ends for 2-3 days before
surgery to washout his gut
Magnesium sulphate to help empty his proximal gut and
to make sure that the next feces he passes is soft
Neomycin, metranidazole may be given perioperativelly
51. Extraperitoneal colostomy closure
Colostomy closure without need to open the
abdomen
It is easy and avoids the risk of contaminating
the peritoneal cavity
Only applied to loop and double-barrel
colostomies
52. Intraperitoneal colostomy closure
The colostomy is closed by opening the
peritoneal cavity
Difficulty procedure as laparotomy is needed
in order to close the colostomy
It has high risk of contaminating the
peritoneal cavity
55. Skin irritation
Skin irritation and infection are the
most common complications with
colostomy
Excoriation from stoma effluent,
candidal infection and dermatitis
are frequent
Improper location or construction
of the stoma and poor stoma care
are often responsible
Local wound care and patient or
caretaker education often corrects
the problem
56. Colostomy necrosis
This is death of the
colostomy tissue
Caused by inadequate
blood supply, this
complication is usually
visible 12–24 hours after
the operation
Usually requires
additional surgery
57. Colostomy bleeding
Minor bleeding can occur with overly vigorous stomal
cleansing
Major bleeding from the stoma itself is uncommon and
usually indicates either a stomal laceration from a poorly
fitting appliance or the development of peristomal varices in
the patient with portal hypertension
Initial management of stomal bleeding involves direct
pressure and AgNO3 cauterization or suturing of the
bleeder if required
Definitive management depends upon the etiology of the
bleeding.
58. Colostomy prolapse
Both proximal and distal bowel
segments can protrude many
centimeters
Colostomy prolapse commonly occurs in
end or loop colostomies
Most often results from an overly large
opening in the abdominal wall or
inadequate fixation of the bowel to the
abdominal wall
Colostomy prolapse can occur in
patients with elevated intraabdominal
pressure, especially if there was
inadequate fixation of the bowel to the
internal abdominal wall
Surgical correction is required when
blood supply is compromised and in
case of obstruction, ulceration, or
chronic bleeding
59. Colostomy retraction
In this case the colostomy is drawn
back into the abdomen
Caused by insufficient stomal length,
this complication may be managed
by use of special pouching supplies
Retraction of a loop colostomy
results in a blowhole configuration
that allows proximal contents to spill
into the distal segment
Revision may be required if distal
diversion is necessary
Permanent colostomy that have
retracted may require surgical
revision
60. Colostomy strictures /stenosis
Colostomy strictures can occur
at the skin and/or fascial levels
Often associated with infection
around the colostomy or
scarring
Mild stenosis can be removed
under local anesthesia
Severe stenosis may require
surgery for reshaping the stoma
Attempts at dilating the
colostomy are usually
unsuccessful and may cause
intestinal perforation
61. Parastomal hernia
Protrusion of viscus in the
abdominal wall next to the
colostomy wound
Predisposing factors
Weak abdominal wall
Large stoma aperture
Obesity
Prior abdominal incisions
Malnutrition
Wound infection
Parastomal hernias usually
require surgical intervention
If severe, the defect in the
abdominal wall should be
repaired and the stoma moved to
another location
62. Intestinal obstruction
Can occur due to adhesion, volvulus, stricture or internal
hernia
Obstruction is usually obvious, and the diagnosis is based on
the patient's history and findings at physical examination and
on plain radiography
In all patients with a bowel obstruction, a nasogastric tube
should be placed for decompression and the patient should
receive intravenous hydration
Prompt surgical exploration is required in patients with
suspected ischemic or gangrenous bowel, clinical
deterioration, or obstruction that does not rapidly resolve with
nonsurgical therapy
64. CONCLUSION
In the last century, there have been dramatic improvements
in surgical techniques for the creation of colostomy
Life with a colostomy has also changed dramatically
The development of enterostomal therapy and the
improvement of colostomy management systems have made
life with a stoma nearly as routine as life with an anus.
“care and expertise are important in creating intestinal
stomas because some patients must live with the technical
result for the rest of their lives”