Challenging Stomas



Permanent ostomy creation is a life-changing event and ostomy construction deserves careful attention. Even under the best of circumstances, problems may occur and this is more so when ostomy creation is difficult. Many of these problems can impact patients’ daily routines and decrease quality of life. They may be minor, ranging from pseudoepitheliomatous hyperplasia and skin irritation, to major, such as peristomal hernia or ischemic necrosis. A significant number of patients with these complications will require reoperation. This chapter will present techniques to minimize the possibility of complications when ostomy construction is difficult and will propose solutions if the surgeon is presented with specific difficult ostomy complications.


Ileal Pouch Anal Anastomosis Rectus Abdominus Middle Colic Artery Pseudoepitheliomatous Hyperplasia Thick Abdominal Wall 
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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Colorectal Surgery, Digestive Diseases InstituteCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic FoundationClevelandUSA

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