Complications / problems of colostomy in infants and children

Abstract

Objective: To determine the frequency of complications/problems occurring with construction of colostomy in infants and children.

Design: Descriptive study.

Place and duration of study: Surgical Unit B, National Institute of Child Health, Karachi, from September 2001 to March 2003.

Patients and methods: All the patients admitted in the unit who required colostomy as part of their management were included in the study. The patients who were operated upon previously or operated elsewhere and referred after having colostomy, were excluded. Problems associated with colostomy construction like skin excoriation and chronic blood loss were also recorded. Chi-square test of proportion was used to determine the p-value.

Results: There were 121 patients. Most of the patients were operated due to anorectal malformations (n=71) and Hirschsprung's disease (41). Complications/problems related to colostomy occurred in 67.7% patients. The most common problem was skin excoriation. Second in rating was chronic blood loss from stoma. Prolapse of stoma was more common in transverse loop colostomies. Divided colostomies had higher number of complications as compared to loop colostomies, similarly, transverse colostomies had high number of complications but in both the cases difference was not statistically significant. Four (3.3%) patients died.

Conclusion: Construction of colostomy in paediatric patients carries high frequency of complications/problems and requires careful technique. The role of stoma care clinic and enterostomal therapist can be instrumental in preventing problems associated with colostomy.