Ileostomy and colostomy

The formation of intestinal stomas, mainly ileostomy and colostomy, has become an integral approach to the surgical management of several pathologies of the gastrointestinal tract – in both the emergency and elective patient. The basic underlying principle is that faecal flow is diverted away from the site of the pathology, by bringing an end or a loop of bowel, through the anterior abdominal wall. Either in a temporary capacity or permanent role stomas can reduce morbidity and mortality associated with several conditions of the gastrointestinal tract such as perforated colon, inflammatory bowel disease, bowel obstruction and elective cancer operations, for example a low anastomosis in an anterior resection of rectum. It has to be appreciated though that stomas are not without their own set of complications, both in the early and late phases. Initial concerns can be due to ischaemia of the bowel forming the stoma, stomal retraction and obstruction through to later complications such as parastomal hernia formation, stomal prolapse and peristomal skin changes.