Complications of Intestinal Stomas and their Management

  • Nihar Ranjan Dash
  • Ragini Kilambi
Part of the GI Surgery Annual book series (GISA, volume 22)


The word stoma is a Greek word that stands for mouth or opening. The earliest descriptions of stomas date back to the thirteenth century when these were exteriorization of lacerated intestinal wounds [1]. The first stoma was a caecostomy done by Pillore for an obstructing rectal cancer in 1776. The patient succumbed on day 28 postoperatively, possibly due to non-operative causes. However, it wasn’t until 1793, that the first successful stoma was created by Duret for an imperforate anus. This was the era of loop stomas. The first attempt at an end stoma was made by Schitsinger and Madelung in 1881. Till then, only the large intestine had been used to create a stoma. Nearly a 100 years after the first colostomy, Maydl in 1883 did the first successful ileostomy. However, the early ileostomies were crude and associated with large volumes of caustic effluent, leading to skin excoriation requiring pouch systems. The effluent also caused serositis of the bowel, leading to dysfunction of the stoma and eventually obstruction. These ileostomies were 2–3 in. long, to avoid contact of the effluent with the skin and were emptied using a catheter. Eventually the catheter was removed and the stoma matured by itself. In 1952, Brooke in his seminal article described a simple technique of mucosal eversion to avoid serositis. This step significantly reduced the complications of ileostomy. However, the problem of a large volume of effluent continued. To overcome these issues, Kock attempted a continent ileostomy, but this too was associated with problems and did not become very popular. Today, as technology and understanding have evolved, we have come a long way from the crude bags used to collect faeces to sophisticated appliances with skin protective barrier pastes and wafers [1–3]. A brief knowledge of this history is useful to understand how surgical advances have been gradually made to overcome complications and drawbacks of existing procedures. The primary aim of creating a stoma is diversion of enteric contents, either temporary or permanent, depending on the underlying pathology.


Familial Adenomatous Polyposis Transjugular Intrahepatic Portosystemic Shunt Early Postoperative Period Loop Ileostomy Parastomal Hernia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We sincerely thank members of Indian Ostomy Society for helping us with some material used in this chapter. We also thank Dr Sujeet Saha, for his inputs in preparation of the manusctipt.


  1. 1.
    Hardy KJ. Surgical history. Evolution of the stoma. Aust N Z J Surg 1989;59:71–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Cataldo PA. Intestinal stomas: 200 years of digging. Dis Colon Rectum 1999;42:137–42.PubMedCrossRefGoogle Scholar
  3. 3.
    Cromar CD. The evolution of colostomy. Dis Colon Rectum 1968;11:367–90.PubMedCrossRefGoogle Scholar
  4. 4.
    Lindholm E, Persson E, Carlsson E, Hallén AM, Fingren J, Berndtsson I. Ostomy-related complications after emergent abdominal surgery: A 2-year follow-up study. J Wound Ostomy Continence Nurs 2013;40:603–10.PubMedCrossRefGoogle Scholar
  5. 5.
    Cottam J, Richards K, Hasted A, Blackman A. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Dis 2007;9:834–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Parmar KL, Zammit M, Smith A, Kenyon D, Lees NP, Greater Manchester and Cheshire Colorectal Cancer Network. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network. Colorectal Dis 2011;13:935–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Park JJ, Del Pino A, Orsay CP, Nelson RL, Pearl RK, Cintron JR, et al. Stoma complications: The Cook County Hospital experience. Dis Colon Rectum 1999;42:1575–80.PubMedCrossRefGoogle Scholar
  8. 8.
    Robertson I, Leung E, Hughes D, Spiers M, Donnelly L, Mackenzie I, et al. Prospective analysis of stoma-related complications. Colorectal Dis 2005;7:279–85.PubMedCrossRefGoogle Scholar
  9. 9.
    Harris DA, Egbeare D, Jones S, Benjamin H, Woodward A, Foster ME. Complications and mortality following stoma formation. Ann R Coll Surg Engl 2005;87:427–31.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Duchesne JC, Wang YZ, Weintraub SL, Boyle M, Hunt JP. Stoma complications: A multivariate analysis. Am Surg 2002;68:961–6; discussion 966.PubMedGoogle Scholar
  11. 11.
    Arumugam PJ, Bevan L, Macdonald L, Watkins AJ, Morgan AR, Beynon J, et al. A prospective audit of stomas—analysis of risk factors and complications and their management. Colorectal Dis 2003;5:49–52.PubMedCrossRefGoogle Scholar
  12. 12.
    Tilney HS, Sains PS, Lovegrove RE, Reese GE, Heriot AG, Tekkis PP. Comparison of outcomes following ileostomy versus colostomy for defunctioning colorectal anastomoses. World J Surg 2007;31:1142–51.PubMedCrossRefGoogle Scholar
  13. 13.
    Chen J, Wang DR, Zhang JR, Li P, Niu G, Lu Q. Meta-analysis of temporary ileostomy versus colostomy for colorectal anastomoses. Acta Chir Belg 2013;113:330–9.PubMedGoogle Scholar
  14. 14.
    Pearl RK, Prasad ML, Orsay CP, Abcarian H, Tan AB, Melzl MT. Early local complications from intestinal stomas. Arch Surg 1985;120:1145–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Bagi P, Jendresen M, Kirkegaard P. Early local stoma complications in relation to the applied suture material: Comparison between monofilament and multifilament sutures. Dis Colon Rectum 1992;35:739–42.PubMedCrossRefGoogle Scholar
  16. 16.
    Bass EM, Del Pino A, Tan A, Pearl RK, Orsay CP, Abcarian H. Does preoperative stoma marking and education by the enterostomal therapist affect outcome? Dis Colon Rectum 1997;40:440–2.PubMedCrossRefGoogle Scholar
  17. 17.
    Carlstedt A, Fasth S, Hultén L, Nordgren S, Palselius I. Long-term ileostomy complications in patients with ulcerative colitis and Crohn’s disease. Int J Colorectal Dis 1987;2:22–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Saghir JH, McKenzie FD, Leckie DM, McCourtney JS, Finlay IG, McKee RF, et al. Factors that predict complications after construction of a stoma: A retrospective study. Eur J Surg 2001;167:531–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Phatak UR, Kao LS, You YN, Rodriguez-Bigas MA, Skibber JM, Feig BW, et al. Impact of ileostomy-related complications on the multidisciplinary treatment of rectal cancer. Ann Surg Oncol 2014;21:507–12.PubMedCrossRefGoogle Scholar
  20. 20.
    Formijne Jonkers HA, Draaisma WA, Roskott AM, van Overbeeke AJ, Broeders IA, Consten EC. Early complications after stoma formation: A prospective cohort study in 100 patients with 1-year follow-up. Int J Colorectal Dis 2012;27:1095–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Londono-Schimmer EE, Leong AP, Phillips RK. Life table analysis of stomal complications following colostomy. Dis Colon Rectum 1994;37:916–20.PubMedCrossRefGoogle Scholar
  22. 22.
    Kann BR. Early stomal complications. Clin Colon Rectal Surg 2008;21:23–30.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Shellito PC. Complications of abdominal stoma surgery. Dis Colon Rectum 1998;41:1562–72.PubMedCrossRefGoogle Scholar
  24. 24.
    Cataldo PA. Technical tips for stoma creation in the challenging patient. Clin Colon Rectal Surg 2008;21:17–22.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Kwiatt M, Kawata M. Avoidance and management of stomal complications. Clin Colon Rectal Surg 2013;26:112–21.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Colwell JC, Beitz J. Survey of wound, ostomy and continence (WOC) nurse clinicians on stomal and peristomal complications: A content validation study. J Wound Ostomy Continence Nurs 2007;34:57–69.PubMedCrossRefGoogle Scholar
  27. 27.
    Hendren S, Hammond K, Glasgow SC, Perry WB, Buie WD, Steele SR, et al. Clinical practice guidelines for ostomy surgery. Dis Colon Rectum 2015;58:375–87.PubMedCrossRefGoogle Scholar
  28. 28.
    Bafford AC, Irani JL. Management and complications of stomas. Surg Clin North Am 2013;93:145–66.PubMedCrossRefGoogle Scholar
  29. 29.
    Husain SG, Cataldo TE. Late stomal complications. Clin Colon Rectal Surg 2008;21:31–40.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Delrio P, Conzo G. Complications of Ileostomy. Semin Colon Rectal Surg 2008;19:140–5.CrossRefGoogle Scholar
  31. 31.
    Brooke BN. The management of an ileostomy, including its complications. Lancet 1952;2:102–4.PubMedCrossRefGoogle Scholar
  32. 32.
    Alvey B, Beck DE. Peristomal dermatology. Clin Colon Rectal Surg 2008;21:41–4.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Lyon CC, Smith AJ, Griffiths CE, Beck MH. The spectrum of skin disorders in abdominal stoma patients. Br J Dermatol 2000;143:1248–60.PubMedCrossRefGoogle Scholar
  34. 34.
    McGarity WC, Robertson DB, McKeown PP, Amerson JR, Darden WA. Pyoderma gangrenosum at the parastomal site in patients with Crohn’s disease. Arch Surg 1984;119:1186–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Wu XR, Mukewar S, Kiran RP, Remzi FH, Hammel J, Shen B. Risk factors for peristomal pyoderma gangrenosum complicating inflammatory bowel disease. J Crohns Colitis 2013;7:e171–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Kiran RP, O’Brien-Ermlich B, Achkar JP, Fazio VW, Delaney CP. Management of peristomal pyoderma gangrenosum. Dis Colon Rectum 2005;48:1397–403.PubMedCrossRefGoogle Scholar
  37. 37.
    Sheldon DG, Sawchuk LL, Kozarek RA, Thirlby RC. Twenty cases of peristomal pyoderma gangrenosum: Diagnostic implications and management. Arch Surg 2000;135:564–8; discussion 568–9.PubMedCrossRefGoogle Scholar
  38. 38.
    Poritz LS, Lebo MA, Bobb AD, Ardell CM, Koltun WA. Management of peristomal pyoderma gangrenosum. J Am Coll Surg 2008;206:311–15.PubMedCrossRefGoogle Scholar
  39. 39.
    Birnbaum W, Ferrier P. Complications of abdominal colostomy. Am J Surg 1952;83:64–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Greenstein AJ, Dicker A, Meyers S, Aufses AH Jr. Periileostomy fistulae in Crohn’s disease. Ann Surg 1983;197:179–82.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Gunnarsson U, Strigård K. 3D intrastomal ultrasonography, an instrument for detecting stoma-related fistula. Tech Coloproctol 2012;16:233–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Hoentjen F, Colwell JC, Hanauer SB. Complications of peristomal recurrence of Crohn’s disease: A case report and a review of literature. J Wound Ostomy Continence Nurs 2012;39:297–301.PubMedCrossRefGoogle Scholar
  43. 43.
    Leong AP, Londono-Schimmer EE, Phillips RK. Life-table analysis of stomal complications following ileostomy. Br J Surg 1994;81:727–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Choi HK, Chu KW, Law WL. Therapeutic value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: A prospective randomized trial. Ann Surg 2002;236:1–6.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Pine J, Stevenson L. Ileostomy and colostomy. Surgery 2014;32:212–17.Google Scholar
  46. 46.
    Castillo E, Thomassie LM, Whitlow CB, Margolin DA, Malcolm J, Beck DE. Continent ileostomy: Current experience. Dis Colon Rectum 2005;48:1263–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Israelsson LA. Parastomal hernias. Surg Clin North Am 2008;88:113–25, ix.PubMedCrossRefGoogle Scholar
  48. 48.
    Carne PW, Robertson GM, Frizelle FA. Parastomal hernia. Br J Surg 2003;90:784–93.PubMedCrossRefGoogle Scholar
  49. 49.
    Aquina CT, Iannuzzi JC, Probst CP, Kelly KN, Noyes K, Fleming FJ, et al. Parastomal hernia: A growing problem with new solutions. Dig Surg 2014;31:366–76.PubMedCrossRefGoogle Scholar
  50. 50.
    Shabbir J, Britton DC. Stoma complications: A literature overview. Colorectal Dis 2010;12:958–64.PubMedCrossRefGoogle Scholar
  51. 51.
    Stothert JC Jr, Brubacher L, Simonowitz DA. Complications of emergency stoma formation. Arch Surg 1982;117:307–9.PubMedCrossRefGoogle Scholar
  52. 52.
    Hotouras A, Murphy J, Thaha M, Chan CL. The persistent challenge of parastomal herniation: A review of the literature and future developments. Colorectal Dis 2013;15:e202–14.PubMedCrossRefGoogle Scholar
  53. 53.
    Devlin HB. Peristomal hernia. In: Rob and Smith’s Operative Surgery: Alimentary Tract and Abdominal wall. London: Butterworths; 1998: 441–3.Google Scholar
  54. 54.
    Strigård K, Gurmu A, Näsvall P, Påhlman P, Gunnarsson U. Intrastomal 3D ultrasound; an inter- and intra-observer evaluation. Int J Colorectal Dis 2013;28:43–7.PubMedCrossRefGoogle Scholar
  55. 55.
    Bayer I, Kyzer S, Chaimoff C. A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia. Surg Gynecol Obstet 1986;163:579–80.PubMedGoogle Scholar
  56. 56.
    López-Cano M, Lozoya-Trujillo R, Quiroga S, Sánchez JL, Vallribera F, Martí M, et al. Use of a prosthetic mesh to prevent parastomal hernia during laparoscopic abdominoperineal resection: A randomized controlled trial. Hernia 2012;16:661–7.PubMedCrossRefGoogle Scholar
  57. 57.
    Jänes A, Cengiz Y, Israelsson LA. Preventing parastomal hernia with a prosthetic mesh: A 5-year follow-up of a randomized study. World J Surg 2009;33:118–21; discussion 122–3.PubMedCrossRefGoogle Scholar
  58. 58.
    Figel NA, Rostas JW, Ellis CN. Outcomes using a bioprosthetic mesh at the time of permanent stoma creation in preventing a parastomal hernia: A value analysis. Am J Surg 2012;203:323–6; discussion 326.PubMedCrossRefGoogle Scholar
  59. 59.
    Fleshman JW, Beck DE, Hyman N, Wexner SD, Bauer J, George V; PRISM Study Group. A prospective, multicenter, randomized, controlled study of non-cross-linked porcine acellular dermal matrix fascial sublay for parastomal reinforcement in patients undergoing surgery for permanent abdominal wall ostomies. Dis Colon Rectum 2014;57:623–31.PubMedCrossRefGoogle Scholar
  60. 60.
    Wijeyekoon SP, Gurusamy K, El-Gendy K, Chan CL. Prevention of parastomal herniation with biologic/composite prosthetic mesh: A systematic review and meta-analysis of randomized controlled trials. J Am Coll Surg 2010;211:637–45.PubMedCrossRefGoogle Scholar
  61. 61.
    Shabbir J, Chaudhary BN, Dawson R. A systematic review on the use of prophylactic mesh during primary stoma formation to prevent parastomal hernia formation. Colorectal Dis 2012;14:931–6.PubMedCrossRefGoogle Scholar
  62. 62.
    Resnick S. New method of bowel stoma formation. Am J Surg 1986;152:545–8.PubMedCrossRefGoogle Scholar
  63. 63.
    Martin L, Foster G. Parastomal hernia. Ann R Coll Surg Engl 1996;78:81–4.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Mavroidis D, Koltun WA. Technique for atraumatic delivery of intestine through the abdominal wall during stoma formation. Dis Colon Rectum 1996;39:461–2.PubMedCrossRefGoogle Scholar
  65. 65.
    Meagher AP, Owen G, Gett R. Multimedia article. An improved technique for end stoma creation in obese patients. Dis Colon Rectum 2009;52:531–3.PubMedCrossRefGoogle Scholar
  66. 66.
    Goligher JC. Extraperitoneal colostomy or ileostomy. Br J Surg 1958;46:97–103.PubMedCrossRefGoogle Scholar
  67. 67.
    Hamada M, Ozaki K, Muraoka G, Kawakita N, Nishioka Y. Permanent end-sigmoid colostomy through the extraperitoneal route prevents parastomal hernia after laparoscopic abdominoperineal resection. Dis Colon Rectum 2012;55:963–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Akamoto S, Noge S, Uemura J, Maeda N, Ohshima M, Kashiwagi H, et al. Extraperitoneal colostomy in laparoscopic abdominoperineal resection using a laparoscopic retractor. Surg Today 2013;43:580–2.PubMedCrossRefGoogle Scholar
  69. 69.
    Lian L, Wu XR, He XS, Zou YF, Wu XJ, Lan P, et al. Extraperitoneal vs. intraperitoneal route for permanent colostomy: A meta-analysis of 1,071 patients. Int J Colorectal Dis 2012;27:59–64.PubMedCrossRefGoogle Scholar
  70. 70.
    Hardt J, Meerpohl JJ, Metzendorf MI, Kienle P, Post S, Herrle F. Lateral pararectal versus transrectal stoma placement for prevention of parastomal herniation. Cochrane Database Syst Rev 2013;11:CD009487.Google Scholar
  71. 71.
    Rostas JW. Preventing stoma-related complications: Techniques for optimal stoma creation. Semin Colon Rectal Surg 2012;23:2–9.CrossRefGoogle Scholar
  72. 72.
    Carne PW, Frye JN, Robertson GM, Frizelle FA. Parastomal hernia following minimally invasive stoma formation. ANZ J Surg 2003;73:843–5.PubMedCrossRefGoogle Scholar
  73. 73.
    Liu J, Bruch HP, Farke S, Nolde J, Schwandner O. Stoma formation for fecal diversion: A plea for the laparoscopic approach. Tech Coloproctol 2005;9:9–14.PubMedCrossRefGoogle Scholar
  74. 74.
    Williams JG, Etherington R, Hayward MW, Hughes LE. Paraileostomy hernia: A clinical and radiological study. Br J Surg 1990;77:1355–7.PubMedCrossRefGoogle Scholar
  75. 75.
    Rubin MS, Schoetz DJ Jr, Matthews JB. Parastomal hernia. Is stoma relocation superior to fascial repair? Arch Surg 1994;129:413–8; discussion 418–9.PubMedCrossRefGoogle Scholar
  76. 76.
    Cheung MT, Chia NH, Chiu WY. Surgical treatment of parastomal hernia complicating sigmoid colostomies. Dis Colon Rectum 2001;44:266–70.PubMedCrossRefGoogle Scholar
  77. 77.
    Allen-Mersh TG, Thomson JP. Surgical treatment of colostomy complications. Br J Surg 1988;75:416–8.PubMedCrossRefGoogle Scholar
  78. 78.
    Hansson BM, Slater NJ, van der Velden AS, Groenewoud HM, Buyne OR, de Hingh IH, et al. Surgical techniques for parastomal hernia repair: A systematic review of the literature. Ann Surg 2012;255:685–95.PubMedCrossRefGoogle Scholar
  79. 79.
    Prian GW, Sawyer RB, Sawyer KC. Repair of peristomal colostomy hernias. Am J Surg 1975;130:694–6.PubMedCrossRefGoogle Scholar
  80. 80.
    Stephenson BM, Phillips RK. Parastomal hernia: Local resiting and mesh repair. Br J Surg 1995;82:1395–6.PubMedCrossRefGoogle Scholar
  81. 81.
    Israelsson LA. Preventing and treating parastomal hernia. World J Surg 2005;29:1086–9.PubMedCrossRefGoogle Scholar
  82. 82.
    Berger D, Bientzle M. Polyvinylidene fluoride: A suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients. Hernia 2009;13:167–72.PubMedCrossRefGoogle Scholar
  83. 83.
    Stelzner S, Hellmich G, Ludwig K. Repair of paracolostomy hernias with a prosthetic mesh in the intraperitoneal onlay position: Modified Sugarbaker technique. Dis Colon Rectum 2004;47:185–91.PubMedCrossRefGoogle Scholar
  84. 84.
    Asif A, Ruiz M, Yetasook A, Denham W, Linn J, Carbray J, et al. Laparoscopic modified Sugarbaker technique results in superior recurrence rate. Surg Endosc 2012;26:3430–4.PubMedCrossRefGoogle Scholar
  85. 85.
    LeBlanc KA, Bellanger DE, Whitaker JM, Hausmann MG. Laparoscopic parastomal hernia repair. Hernia 2005;9:140–4.PubMedCrossRefGoogle Scholar
  86. 86.
    Ellis CN. Short-term outcomes with the use of bioprosthetics for the management of parastomal hernias. Dis Colon Rectum 2010;53:279–83.PubMedCrossRefGoogle Scholar
  87. 87.
    Slater NJ, Hansson BM, Buyne OR, Hendriks T, Bleichrodt RP. Repair of parastomal hernias with biologic grafts: A systematic review. J Gastrointest Surg 2011;15:1252–8.PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Quah HM, Samad A, Maw A. Ileostomy carcinomas a review: The latent risk after colectomy for ulcerative colitis and familial adenomatous polyposis. Colorectal Dis 2005;7:538–44.PubMedCrossRefGoogle Scholar
  89. 89.
    Pranesh N. Lymphoma in an ileostomy. Postgrad Med J 2002;78:368–9.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Reissman P, Avroutis O, Cohen DY, Shiloni E. Ileostomy-site colonic metaplasia with adenocarcinoma after proctocolectomy for ulcerative colitis. Am J Gastroenterol 1997;92:1932–3.PubMedGoogle Scholar
  91. 91.
    Gorbach SL, Nahas L, Weinstein L, Levitan R, Patterson JF. Studies of intestinal microflora. IV. The microflora of ileostomy effluent: A unique microbial ecology. Gastroenterology 1967;53:874–80.PubMedGoogle Scholar
  92. 92.
    Gadacz TR, McFadden DW, Gabrielson EW, Ullah A, Berman JJ. Adenocarcinoma of the ileostomy: The latent risk of cancer after colectomy for ulcerative colitis and familial polyposis. Surgery 1990;107:698–703.PubMedGoogle Scholar
  93. 93.
    Hammond K. Ostomy hemorrhage: Diagnosis and current therapeutic options. Semin Colon Rectal Surg 2012;23:17–19.CrossRefGoogle Scholar
  94. 94.
    Ricci RL, Lee KR, Greenberger NJ. Chronic gastrointestinal bleeding from ileal varices after total proctocolectomy for ulcerative colitis: Correction by mesocaval shunt. Gastroenterology 1980;78 (5 Pt 1):1053–8.PubMedGoogle Scholar
  95. 95.
    Conte JV, Arcomano TA, Naficy MA, Holt RW. Treatment of bleeding stomal varices. Report of a case and review of the literature. Dis Colon Rectum 1990;33:308–14.PubMedCrossRefGoogle Scholar
  96. 96.
    Arulraj R, Mangat KS, Tripathi D. Embolization of bleeding stomal varices by direct percutaneous approach. Cardiovasc Intervent Radiol 2011;34 Suppl 2:S210–3.PubMedCrossRefGoogle Scholar
  97. 97.
    Samaraweera RN, Feldman L, Widrich WC, Waltman A, Steinberg F, Greenfield A, et al. Stomal varices: Percutaneous transhepatic embolization. Radiology 1989;170 (3 Pt 1):779–82.PubMedCrossRefGoogle Scholar
  98. 98.
    Shibata D, Brophy DP, Gordon FD, Anastopoulos HT, Sentovich SM, Bleday R. Transjugular intrahepatic portosystemic shunt for treatment of bleeding ectopic varices with portal hypertension. Dis Colon Rectum 1999;42:1581–5.PubMedCrossRefGoogle Scholar
  99. 99.
    Noubibou M, Douala HC, Druez PM, Kartheuzer AH, Detry RJ, Geubel AP. Chronic stomal variceal bleeding after colonic surgery in patients with portal hypertension: Efficacy of betablocking agents? Eur J Gastroenterol Hepatol 2006;18:807–8.PubMedCrossRefGoogle Scholar
  100. 100.
    Pennick MO, Artioukh DY. Management of parastomal varices: Who re-bleeds and who does not? A systematic review of the literature. Tech Coloproctol 2013;17:163–70.PubMedCrossRefGoogle Scholar
  101. 101.
    Tepetes K, Spyridakis M, Hatzitheofilou C. Local treatment of a loop colostomy prolapse with a linear stapler. Tech Coloproctol 2005;9:156–8.PubMedCrossRefGoogle Scholar
  102. 102.
    Abulafi AM, Sherman IW, Fiddian RV. Délorme operation for prolapsed colostomy. Br J Surg 1989;76:1321–2.PubMedCrossRefGoogle Scholar
  103. 103.
    Porter JA, Salvati EP, Rubin RJ, Eisenstat TE. Complications of colostomies. Dis Colon Rectum 1989;32:299–303.PubMedCrossRefGoogle Scholar
  104. 104.
    Nunoo R, Asgeirsson T. Stomal strictures. Semin Colon Rectal Surg 2012;23:10–12.CrossRefGoogle Scholar
  105. 105.
    Colwell JC. Stomal and peristomal complications. In: Colwell JC, Goldberg MT, Carmel JE. Fecal & urinary diversions: Management principles. St Louis, MO: Mosby; 2004: 310–14.Google Scholar
  106. 106.
    Barr JE. Assessment and management of stomal complications: A framework for clinical decision making. Ostomy Wound Manage 2004;50:50–2, 54, 56.Google Scholar
  107. 107.
    Riaz AA, Jeetle SS, Bobb KA, Jones PW, Thompson HH. Stomal plugs: A novel treatment option for stomal stenosis. Tech Coloproctol 2005;9:172.PubMedGoogle Scholar
  108. 108.
    Kim WH, Kwon CI, Kim JW, Lee C. Insertion of a self-expanding metal stent for a stomal stenosis. Endoscopy 2012;44 Suppl 2 UCTN:E143–4.Google Scholar
  109. 109.
    Beraldo S, Titley G, Allan A. Use of W-plasty in stenotic stoma: A new solution for an old problem. Colorectal Dis 2006;8:715–16.PubMedCrossRefGoogle Scholar
  110. 110.
    Lyons AS, Simon BE. Z-plasty for colostomy stenosis. Ann Surg 1960;151:59–62.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    Baker ML, Williams RN, Nightingale JM. Causes and management of a high-output stoma. Colorectal Dis 2011;13:191–7.PubMedCrossRefGoogle Scholar
  112. 112.
    Arenas Villafranca JJ, López-Rodríguez C, Abilés J, Rivera R, Gándara Adán N, Utrilla Navarro P. Protocol for the detection and nutritional management of high-output stomas. Nutr J 2015;14:45.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Fontes B, Fontes W, Utiyama EM, Birolini D. The efficacy of loop colostomy for complete fecal diversion. Dis Colon Rectum 1988;31:298–302.PubMedCrossRefGoogle Scholar
  114. 114.
    Merrett ND, Gartell PC. A totally diverting loop colostomy. Ann R Coll Surg Engl 1993;75:272–4.PubMedPubMedCentralGoogle Scholar
  115. 115.
    Mahjoubi B, Moghimi A, Mirzaei R, Bijari A. Evaluation of the end colostomy complications and the risk factors influencing them in Iranian patients. Colorectal Dis 2005;7:582–7.PubMedCrossRefGoogle Scholar
  116. 116.
    Ang SG, Chen HC, Siah RJ, He HG, Klainin-Yobas P. Stressors relating to patient psychological health following stoma surgery: An integrated literature review. Oncol Nurs Forum 2013;40:587–94.PubMedCrossRefGoogle Scholar
  117. 117.
    Danielsen AK, Burcharth J, Rosenberg J. Patient education has a positive effect in patients with a stoma: A systematic review. Colorectal Dis 2013;15:e276–83.PubMedCrossRefGoogle Scholar
  118. 118.
    Kim JT, Kumar RR. Reoperation for stoma-related complications. Clin Colon Rectal Surg 2006;19:207–12.PubMedPubMedCentralCrossRefGoogle Scholar
  119. 119.
    Persson E, Berndtsson I, Carlsson E, Hallén AM, Lindholm E. Stoma-related complications and stoma size—a 2-year follow up. Colorectal Dis 2010;12:971–6.PubMedCrossRefGoogle Scholar
  120. 120.
    Ayeni IV, Williams NJ. An unusual cause of a non-functioning stoma in an 87-year-old gentleman. BMJ Case Rep 2012:2012.Google Scholar
  121. 121.
    Fingren J, Lindholm E, Carlsson E. Perceptions of phantom rectum syndrome and health-related quality of life in patients following abdominoperineal resection for rectal cancer. J Wound Ostomy Continence Nurs 2013;40:280–6.PubMedCrossRefGoogle Scholar

Copyright information

© T.K. Chattopadhyay 2015

Authors and Affiliations

  • Nihar Ranjan Dash
    • 1
  • Ragini Kilambi
    • 1
  1. 1.Department of Gastrointestinal Surgery and Liver TransplantationAll India Institute of Medical SciencesNew DelhiIndia

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