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What is a Colostomy ?


A colostomy is a surgical procedure which involves opening of the colon to the exterior for the drainage of faecal matter.

A colostomy may be temporary or permanent.


When is a Colostomy required ?

A colostomy is indicated in the following conditions-
  • Congenital conditions
  • In cases of Hirschsprung’s disease or anorectal anomalies, a temporary colostomy is done.
  • Carcinoma
  • In case of rectal carcinomas where an abdomino-peritoneal resection is performed, a permanent end-sigmoid colostomy is done following the procedure.
  • Colonic fistulae
  • Fistulas of the colon occurring as a consequence of diverticulitis, Crohn’s disease or due to tuberculosis, requie a colostomy during their management.
  • Colonic injuries
  • Trauma to the colon due to stab wounds or injuries during an operative procedure like nephrectomy or a percutaneous nephrolithotomy, leads to colonic injuries which require a period of rest to heal. A colostomy is hence performed during the management.



Types of colostomy
  • Temporary colostomy: A temporary colostomy is indicated in cases of an acute left sided colonic obstruction, traumatic fistula or a congenital fistula affecting the left colon.
    In cases of an acute left sided colonic obstruction, proximal half of the right transverse colon is brought to the exterior through the upper part of the rectus abdominus muscle. This is later on followed by a radical resection of the left colon after which the colostomy is closed.
    In cases of a fistula, either traumatic or congenital, affecting the left colon, the loop of the colon which is brought out is held in place with the help of a glass rod. This is then passed through the transverse mesocolon and held by rubber tube. The rod is removed after 10 days.


  • Permanent colostomy: A permanent colostomy is indicated after an abdominoperitoneal resection. The end of the sigmoid colon is brought to the exterior in the left iliac fossa as a permanent colostomy. The colostomy site is created 3 cm away from the anterior superior iliac spine to make sure that the colostomy bag can be fitted properly.


  • Double barreled colostomy: A double barreled colostomy involves crushing of the adjoining walls of the intestine. Both the ends of the loop are defunctioned. This type of colostomy was done earlier for sigmoid  volvulus, resection of colonic stricture etc. This method is not used anymore.



What are the benefits of a colostomy procedure ? How is it useful ?

Once a colostomy is done, the length of the colon distal to the site of colostomy takes complete rest. This helps it heal and regain normal size and function. The bacterial colonization is reduced.
As this part of the colon is not used, it becomes empty and sterile. This reduces the chances of leakage from the bowel after surgery, when done at a later date.


What are its complications ?

The complications of colostomy include bleeding from the site, necrosis of the surrounding tissue, retraction of the bowel, prolapse, parastomal hernia which is herniation of the abdominal viscera occurring around the site of the colostomy as the area around has been weakened by the procedure.
Colostomy diarrhea may also occur as a complication.

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