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Complications of Intestinal Stomas and their Management

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GI Surgery Annual

Part of the book series: GI Surgery Annual ((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.

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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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  1. Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, 110029, India

    Nihar Ranjan Dash & Ragini Kilambi

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  1. Nihar Ranjan Dash
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  2. Ragini Kilambi
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Editors and Affiliations

  1. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India

    Peush Sahni

  2. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India

    Sujoy Pal

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© 2015 T.K. Chattopadhyay

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Dash, N.R., Kilambi, R. (2015). Complications of Intestinal Stomas and their Management. In: Sahni, P., Pal, S. (eds) GI Surgery Annual. GI Surgery Annual, vol 22. Springer, Singapore. https://doi.org/10.1007/978-981-10-2010-0_4

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  • DOI: https://doi.org/10.1007/978-981-10-2010-0_4

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-2009-4

  • Online ISBN: 978-981-10-2010-0

  • eBook Packages: MedicineMedicine (R0)

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