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Complications of Intestinal Stomas and their Management

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

Abstract

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.

Keywords

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.

Notes

Acknowledgement

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.

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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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