Colostomy in children: indications and common problems in Benin City, Nigeria

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 2.81. 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: