Stomas

Question 1

What are stomas?

Answer 1

Artificial openings of hollow organs onto the skin surface
Most commonly bowel or ureters
Allows for drainage of contents and bypasses distal organs
Have a specialised bag enclosing them which can be changed when full

Question 2

What are ileostomies?

Answer 2

Stomas of the ileal bowel
Often in RIF
Drain more liquid faeces
Have a nozzle that stops contents from coming into contact with the skin

Question 3

What is an end ileostomy?

Answer 3

When there is one opening onto the skin

Generally permanent after removal of large bowel e.g. in UC treatment

Question 4

What is a loop ileostomy?

Answer 4

When there are two openings
Done after surgery on the bowel to allow the bowel to rest before being anastomosed in 6-8wks time
Allows functional relief to also be provided

Question 5

What is a colostomy?

Answer 5

Stoma formation of the colon
Often on left hand side
Opening directly onto the skin and contains more faeces
Can be loop or end but end is more common

Question 6

When are end colostomies completed?

Answer 6

In Hartmanns procedure- often temporary after emergency large bowel surgery
Post left hemicolectomy
Rectal pathology

Question 7

What is a urostomy?

Answer 7

To allow drainage of urine directly from the kidneys and bypasses the ureters
Often done post cystectomy
Stoma is created via a section of disconnected ileum
Must have a tight fitting bag to ensure that no urine comes into contact with skin as would cause irritation

Question 8

What are early complications of stomas?

Answer 8

Infection
Infarction and necrosis
High stoma output leading to infection

Question 9

What are late complications of stomas?

Answer 9

Stenosis- narrowing of opening
Retraction- opening falls below skin surface
Prolapse- other bowel enters stoma opening
Parastomal hernia- incisional hernia into surgical wound

Question 10

What are other complications?

Answer 10

Bleeding
Psychosocial impact
Granulomas
Skin irritation