A case study of stoma

A 79-year-old grandfather with a prolapsed stoma came to consult our stoma specialist. After seeing the stoma specialist, he said that the prolapse was very serious and he needed to seek medical attention in time. Stoma prolapse is also the most serious stoma complication. The most common one is manifested as a full-thickness protrusion of the bowel wall through the stoma. The incidence of stoma prolapse varies widely, often depending on the type and location of the stoma. Pain and bleeding from skin lesions and ostomy device use disorders are the most common symptoms of stoma prolapse. The picture below shows the grandfather's stoma prolapse:

Why does the stoma prolapse and what are the reasons?

① The patient's abdominal wall will be weak due to factors such as old age, obesity, and repeated operations. Obesity will also affect increased intra-abdominal pressure and chronic obstructive pulmonary disease. The colon is long and the fascia is weak.

②The long-term force on the abdomen will cause excessive intra-abdominal pressure, such as chronic cough, lifting heavy objects, forced urination, defecation, etc., which will lead to increased abdominal pressure, and eventually lead to the prolapse of the intestinal segment from the enterostomy, and the length of the prolapse varies with the intra-abdominal pressure. increased pressure.

③ During the operation, the opening of the muscle layer at the abdominal stoma is too large or the seromuscular layer is trimmed too much, and the intestinal tube is not fixed firmly on the abdominal wall, which may also easily lead to prolapse of the stoma.

How to prevent stoma prolapse?

①Strictly observe the precautions during ostomy surgery. Special attention should be paid to the operation links including the selection of the stoma site, the method of establishing the abdominal wall channel, and the method of parenteral placement.

②The ideal stoma site should be kept away from various bony bulges, skin folds, old scars, umbilicus, belt line, and the site that may become a surgical incision. Follow the "two fingers" principle, that is, the stoma can accommodate two fingers to pass through, and its size is suitable.

③ When the colon is placed externally through the stoma, special attention should be paid to the good blood supply of the bowel. Excessive bowel tubes proximal to the stoma should be resected to reduce the incidence of prolapse.

④According to experience, the use of the extraperitoneal stoma method compared with the conventional intraperitoneal stoma method, stoma complications including prolapse occurred less frequently.

How is stoma prolapse treated?

① Longterm Medical Ostomy Belt can be used to support the function of fixed pressure.

②When the colostomy prolapses, you can lie down and relax. The medical staff wear gloves, cover the mucous membrane of the colostomy with cold saline gauze and slowly push the intestinal tube back into the abdominal cavity.

③ When the stool discharged from the single-lumen sigmoid colostomy or single-lumen descending colostomy is not liquid, the round nipple can be cut first, and then plugged at the enterostomy. Put the pacifier back in. If the stoma at the distal end of the loop enterostomy is prolapsed, fix the nipple on the bottom ring of the stoma chassis and plug the nipple at the distal opening to prevent the stoma from protruding here.

④ If the stoma cannot be pushed back, it is necessary to redo the stoma surgery.

Health Tips:

Carry out aerobic activities such as walking, and usually do some light housework, but do not lift heavy objects, let alone hold children. In terms of diet, eat more crude fiber and easy-to-digest foods. You can eat small and frequent meals. Don't eat too much at a time. After confirming that there is no physical discomfort, increase the number of meals. Avoid cold and stimulating foods, and eat less fried and gas-producing foods. must pay attention to dietary hygiene. If you need to eat out, bring anti-diarrheal medicine and antibiotics to prevent symptoms such as diarrhea. In addition to the above points that need to be paid attention to by patients with a stoma, attention must also be paid to taking a bath, mainly showering, covering the stoma with an ostomy bag and pasting the base with a waterproof tape, or directly removing the stoma bag and using neutral soap Or do not use too much force when using the body wash, avoid scrubbing the stoma or bumping the stoma. Usually, wear loose and comfortable clothes, do not wear tight clothes, and avoid compression and friction of the stoma, which will affect blood circulation.

For more information on Innomed® ostomy, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

At Longterm Medical, we transform this data by innovating and developing products that make life easier for those who need loving care.

Editor: kiki Jia

Date: September 23, 2022