Name of Patient: Jesus Lozada Casabuena

Chief Complaint: Difficulty of Breathing

Diagnosis: Pneumonia in an Immunocompromised host; PTB4; T/C colonic CA S/P

Colostomy; Pleural Effusion (Left) probably parapneumonic

Health Teachings
Colostomy
Intervention:
Colostomy

Line drawing showing a permanent colostomy for rectal

cancer.

A colostomy is a surgical procedure that involves connecting a part of the colon onto the
anterior abdominal wall, leaving the patient with an opening on the abdomen called a
stoma. In a colostomy, the stoma is formed from the end of the large intestine, which is
drawn out through the incision and sutured to the skin. After a colostomy, feces leave the
patient's body through the abdomen. A colostomy may be permanent or temporary,
depending on the reasons for its use.

There are many reasons for this procedure. Some common reasons are:

• A section of the colon has been removed, e.g. due to colon cancer requiring a total
mesorectal excision, diverticulitis, injury, etc, so that it is no longer possible for
feces to exit via the anus.
• A portion of the colon (or ileum) has been operated upon and needs to be 'rested'
until it is healed. In this case, the colostomy is often temporary and is usually
reversed at a later date, leaving the patient with a small scar in place of the stoma.
Children undergoing surgery for extensive pelvic tumors commonly are given a
colostomy in preparation for surgery to remove the tumor, followed by reversal of
the colostomy.
Options
Placement of the stoma on the abdomen can occur at any location along the colon, the
majority being on the lower left side near or in the sigmoid colon, other locations include;
the ascending, transverse, and descending sections of the colon.[citation needed]

Colostomy surgery that can be planned ahead often has a higher rate of
long-term success Colostomy with irrigation

People with colostomies who have ostomies of the sigmoid colon or descending colon
may have the option of irrigation, which allows for the person to not wear a pouch, but
rather just a gauze cap over the stoma, and to schedule irrigation for times that are
convenient. To irrigate, a catheter is placed inside the stoma, and flushed with water,
which allows the feces to come out of the body into an irrigation sleeve. Most
colostomates irrigate once a day or every other day, though this depends on the person,
their food intake, and their health.[citation needed]

Colostomy without irrigation

Colostomies are viewed negatively due to the misconception that it is difficult to hide the
pouch and the smell of feces, or to keep the pouch securely attached.[citation needed] However,
modern colostomy pouches are well-designed, odor-proof, and allow stoma patients to
continue normal activities. Latex-free tape is available for ensuring a secure attachment.
People with colostomies must wear an ostomy pouching system to collect intestinal
waste. Ordinarily the pouch must be emptied or changed several times a day depending
on the frequency of activity; in general the further from the anus (i.e., the further 'up' the
intestinal tract) the ostomy is located the greater the output and more frequent the need to
empty or change the pouch.

In some rare situations it may be possible to opt for an internal colo-anal pouch which
eliminates the need for an external pouch.[citation needed] In place of an external appliance, an
internal ileo-anal pouch is constructed using a portion of the patient's lower intestine, to
act as a new rectum to replace the removed original.

Prepared by: RC AMOR R. VAGILIDAD

Checked by: SHARON ROSE GOLINGAY

Understood by: ___________________________