Colostomy

                              Colostomy
Ostomy- is an opening from the lumen of the out of the abdominal wall.
- it can either be done in upper part of the gut ( gastrostomy, jejunostomy) for purpose of feeding or in the lower part,  for the purpose of let the contents of gut out ( relieve obstruction).

Colostomy - is an opening of the colon to the abdominal wall for the purpose of emptying the gut.

Types of colostomy.
A).  According to anatomical site
       - Gastrostomy
       - jejunostomy
       - caecostomy
       - ileostomy
       - ascending colostomy
       - Transverse colostomy
       - other part of colon colostomy
B).  According to the way the stoma is.                  raised.
       1. Loop - is the most common, easy to.                perform, is closed extra peritoneally.

       2. Double Barrel - is type of colostomy.                 modified by stitching the last few.                   centimeters of its limbs inside the                   abdomen.

       3. Spectacle - is one in which limbs.                    separate by a small bridge of skin.                  Used when the patient need a.                          colostomy for a long time. Closed.                    intra peritoneally.
       4. Hartmanns/Permanent/Terminal/End            - form the end of the gut after.                           excision of rectum.  The distal loop of             the bowel is closed and left back into.             the abdomen.
       5. Mucus fistula colostomy - distal                        opening of the distal loop.

C).  According to the purpose
       1. Temporary
       2. Permanent

Indications
1. Feeding
2. Relieve of bowel obstruction /diversion of faeces in:-
- congenital bowel anomalies like hirschprungs disease, congenital anorectal malformations.
- trauma of the colon,  or anorectal Canal
- crohns diseases
- facilitate cure of fistula
- colorectal carcinoma
- others

Caecostomy
- done patients with caecal injury and caecal distal injury,  distal obstruction or when the patient is too sick for colostomy.
- one of disadvantages of caecal colostomy is divert little faecal materials unless large tube is placed. Also it has the risk to risk peritoneum during construction.

Transverse colostomy
- done in case of left side injury,  left side carcinoma,  or congenital anorectal malformation.

Sigmoid colostomy
-  alternative to transverse colostomy,  used in case sigmoid or rectum obstruction like in case of sigmoid volvulus.

Complications of colostomy
-prolapse
-retraction
-necrosis of distal end
-stomal stenosis
-stomal bleeding
-colostomy diarrhea secondary to infection.

Care of colostomy
1. Apply of colostomy bags
2. Avoid gas forming food
3. Irrigation of end colostomy
4. Medication to slow intestinal function during social occasion.