Indications and outcome of small and large bowel stomas in emergency intestinal surgery

ABSTRACT

To evaluate the indications and outcome of small and large bowel stomas made during emergency intestinal surgery. Cross sectional study. Dow University of Health Sciences Civil Hospital Karachi, from January 2006 to December 2012. All emergency exploratory laparotomies performed for intestinal surgery, managed by stoma were included in this study. Decision for making stoma was based upon etiology, condition of the gut and judgment of the operating surgeon. Total numbers of patients were 200 [male 114, female 86] with mean age of 32.7 year. Trauma was the most common etiology. Firearm injury was the commonest mode [n=67, 33.5%] followed by stab wounds and blunt trauma [n= 12, 6.0%]. Patients also presented with perforation leading to peritonitis [n=65, 32.5%] and intestinal obstruction [n=52, 26%]. Tuberculosis was diagnosed in 5 [26.5%] patients, typhoid perforations in 35 [17.5%] and malignancy in 30 [15%] cases. The mortality in this series was 10%. Wound infection occurred in 42 [21%], burst abdomen in 10[5%] and enterocutaneous fistula and stoma retraction noticed in 6 [3%] patients. Stoma formation was a helpful adjunct surgical procedure performed in emergency intestinal surgery for various conditions with satisfactory outcome: