ABSTRACT
To evaluate the indications for colostomy and highlight associated problems as well as its contribution to the successful treatment of children. This is a retrospective study of the indications, complications, parents/caregivers acceptance and outcome of colostomy in children over a ten-year period at the University of Benin Teaching Hospital, Benin City, Nigeria. There were 46 children aged two days and 15 years [mean 3 months +/- 2.1] with male/female ratio 2.8:1. Congenital anomaly was the major indication and accounted for 40 [87%] with associated higher morbidity and mortality and an observed significant statistical difference compared with the acquired indications [P < 0.0001]. Anorectal anomaly accounting for 22 [48%] and Hirschsprung's disease 18 [39%] were the congenital indications. Morbidity and mortality were mostly associated with children that had anorectal anomaly [P = 0.0021]. Acquired indications were mainly rectovaginal fistulae, perineal and left colonic injury which accounted for 6 [13%]. Skin excoriation 39 [85%], colostomy prolapse 15 [33%] and persistent odour 21 [46%] resulted in poor acceptance by 10 [22%] parents/caregivers. Adequate preoperative counselling, skin protective paste and regular washing of colostomy site alleviated the complications. Wound infection and overwhelming sepsis were difficult to control in 14 [31%] with resultant six [13%] mortalities. Colostomy still has much to offer in emerging paediatric surgery units. Adequate preoperative counselling of parents/caregivers, good stoma care and early stoma closure gave good results in our setting