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Y4 - Surgery - General > Stoma > Flashcards

Flashcards in Stoma Deck (18)
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1
Q

ESSENCE

A

Artificial opneings of a hollow organ (such as bowel), allowing it to drain

Stoma bag is fitted around stoma to collect waste products and emptied as required

2
Q

What are the different procedures that use stomas?

A
  • Colostomy
  • Ileostomy
  • Gastrostomy
  • Urostomy
3
Q

What is colostomy

A
  • Large intestine brought onto skin
  • Draisn more solid stools as much of water is reasborbed in remaining large intesting
  • Can be flatter to skin as solid contents are less irritating to skin
4
Q

Where are colostomies typically located

A

Left iliac fossa

5
Q

What is ileostomy

A
  • End portion of small bowel (ileum) brought onto skin
  • Drains more liquid stools as fluid normally reabsorbed later in large intestine
  • Need spout to avoid contact with skin
6
Q

Where are ileostomy typically located

A

Right iliac fossa

7
Q

What is gastrotomy

A
  • Artificial connection between stomach and abdominal wall
  • Used to provide feeds directly to stomach in patients that cannot meet nutritional needs by mouth
8
Q

What is PEG

A

Percutaneous endoscopic gastrotomy - gastrotomy fitted by an endoscopy procedure

9
Q

What is urostomy

A
  • Opening from urinary system onto skin
  • Needs sprout to avoid skin contact
10
Q

Where is urostomy typically located

A

Right iliac fossa

11
Q

What is an end colostomy

A
  • Created after removal of section of bowel where end of proximal portion is brought to skin and faeces able to drain out into stoma bag
  • Other end remains in bowel sutured, may be reversed at later date where two ends are sutured together
12
Q

When are end colostomy permanent

A

After resection of abdomino-perineal resection (APR) because entire rectum and anus has been rmeoved

13
Q

When does end ileostomy become permanent

A

After panproctocolectomy (total colectomy with removal of large bowel, rectum and anus) such as in IBD or FAP

14
Q

What is alternative to end ileostomy

A
  • Ilio-anal anastomosis (J pouch)
    • Ileum folded back on itself and made into larger pouch that functions like rectum, attached to anus and can collect stool prior to passage
15
Q

What is loop colostomy

A
  • Temporary colostomy used to allow distal portion of bowel and the anastomosis to heal after surgery, before being reversed 6-8 weeks later
  • Bowel partially opened and folded so two openings on skin side by side, attached in the middle
16
Q

When is urostomy used

A

After cystectomy (removal of bladder)

17
Q

How is urostomy formed

A
  • Creating ileal conduit
    • Section of ileum (15-20cm) removed and end-to end anastomosis created so bowel is continuous
    • Ends of ureters are anastomosed to the seperated section of ileum, where end section is brought out onto skin to stoma to drain urine
18
Q

Complications of stoma

A
  • Psycho-social impact
  • Local skin irritation
  • Parastomal hernia
  • Loss of bowel length leading to high output, dehydration and malnutrition
  • Constipation (colostomies)
  • Stenosis
  • Obstruction
  • Retraction (sinking into the skin)
  • Prolapse (telescoping of bowel through hernia site)
  • Bleeding
  • Granulomas causing raised red lumps around the stoma