INDICATIONS AND MORBIDITY OF TEMPORARY LOOP ILEOSTOMY IN A TERTIARY CARE CENTER

Dr. Ashutosh Mangla; Dr. Sharad Seth

Volume : VIII, Issue : I, January - 2019

INDICATIONS AND MORBIDITY OF TEMPORARY LOOP ILEOSTOMY IN A TERTIARY CARE CENTER

Dr. Ashutosh Mangla, Dr. Sharad Seth

Abstract :

Introduction: Ileostomy is an opening constructed between the ileum and the abdominal wall. Faecal diversion through a temporary stoma in cases of perforation peritonitis can be a life saving measure and can reduce the incidence of anastomotic leaks in distal colorectal anastomosis. This study was undertaken to look into the indications for performing this common surgical procedure and to analyse whether a correctly performed ileostomy can reduce local complications so commonly associated with this procedure. Aim and Objectives: To study the demography, etiology and pathology of conditions necessitating a temporary loop ileostomy and morbidity in patients with the same. Methods: This was a prospective observational study over a period of one year on 50 patients of loop ileostomy. Age, gender, indications, systemic and local complications of the procedure, morbidity, post-operative hospital stay and mortality were recorded in a previously prepared proforma for this purpose. Psychological problems of the patients, timing of reversal of loop ileostomy and subsequent follow up of the patients were also studied. Result: The mean age for performing an ileostomy was 35.26 � 19.3 years. Males accounted for 70% of the patients. Non-specific perforation was the commonest cause (32%), followed by typhoid and tubercular perforation, eachin 18% patients.Trauma 12%, intestinal obstruction 10%, strangulated hernia 6%, mesenteric ischaemia 2% and colonic carcinoma 2% accounted for the rest. Surgical site infection was the commonest local complication in 30% patients followed by skin excoriation (18%) patients, burst abdomen (16%), intestinal obstruction (10%) patients, prolapse and bleeding (6%) patients, retraction (4%) and stenosis in (2%) patients. 74.47% of patients developed psychological imbalances ranging from anxiety, depression, loss of confidence and fear of rejection. Conclusion: Loop ileostomy is a life-saving procedure commonly performed in the setting of perforation peritonitis. A meticulous surgical technique ensuring a spout of 4-6 cm. above the skin margin can go a long way in reducing skin excoriation and facilitating early closure of the temporary stoma. Educating and counseling the patient on stoma care goes a long way in helping patients cope with this distressing albeit temporary condition.