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Research Paper | Surgery | India | Volume 12 Issue 1, January 2023
A Prospective Observational Study to Assess the Post Operative Complications of Loop Enterostomies in Cases of Perforation Peritonitis
Hariraj N | Rajan B Somani [3]
Abstract: Introduction: A common surgical technique called an enterostomy creates an external interface between the distal end of the small or large intestine and the abdominal wall. A temporary loop enterostomy is justified in order to provide de - functioning in the event of possibly fatal anastomotic complications with a clear mortality risk. Fecal diversion using a transient stoma can lessen the symptoms of anastomotic leak and the frequency of procedures linked to leaks. Stomas usually carry a lot of morbidities starting from mental trauma affecting the patient to physical morbidities like skin excoriations, obstruction, prolapse, retraction, ulceration of stoma and rare parastomal hernias and to study the risk factors associated with this development. Aim: To assess the post operative complications associated with loop enterostomies in cases of perforation peritonitis. Primary Objectives: To assess the types and rate of occurrence of complications in loop enterostomies in cases of perforation peritonitis. Secondary Objectives: To assess the association of complications with risk factors like diabetes, overweight, previous abdominal surgeries. Methodology: 50 patients who underwent loop enterostomies for perforation peritonitis were assessed in prospective observational study during a period of 9 months from september 2021 to June 2022. Only loop enterostomies and perforation peritonitis cases from both sexes were included and End enterostomies were excluded. Variables included were age, gender, overweight (BMI), skin excoriations, obstruction of stoma, ulcerations of stoma, retractions of stoma, prolapse of stoma, parastomal hernia and haemorrhage. Result: The most common post operative complications associated with loop enterostomies done in cases of perforation peritonitis were skin excoriations (50%), ulceration of stoma (10%), retraction of stoma (6%), prolapse (4%), parastomal hernias (4%), haemorrhage (4%), and necrosis (2%) of stoma. Diabetes was found to be a risk factor for the development of post operative complications like necrosis ulceration and retraction of stoma. Obesity was found to be a risk factor for the development of necrosis and retraction of stoma. Conclusion: In this study, skin excoriation was discovered to be the main problem.50% of patients had peristomal skin issues, and incorrect siting and postoperative care are likely to blame. Since patients who appear late are typically in shock when they do, it is frequently impossible to label the stoma site in an emergency situation when the patient is both standing and seated. In these circumstances, it can be challenging to assess the waistline and skin folds in patients with high BMI. Obesity was found out to be a major risk factor in the development of retraction and necrosis of stoma The probable reasons for retraction in patients with obesity are a thickened fatty mesentery making mobilization of the bowel loop more difficult and traction is exerted on the bowel wall and further causing compression and necrosis of stoma. Diabetes was also a risk factor for the development of post operative complications like retraction necrosis and ulceration of stoma.
Keywords: Loop Enterostomies, Perforation Peritonitis, BMI, Skin Excoriation, Prolapse, Necrosis, Ulceration, Prolapse, Parastomal Hernias, Hemorrhage
Edition: Volume 12 Issue 1, January 2023,
Pages: 1058 - 1065