Professional Documents
Culture Documents
parastomal hernia
fistula
press
I
j Number of
Typeof stoma
content bleeding Skin extoriation
opening
branches
g 3
I J
T
Stoma examination (by Dr Ikhwan Sani)
1. Stoma examination
the skin)
● No bleeding point
● Wear gloves, prepare gauze and yellow bag, open the drainage bag
● Palpation
content)
● Pak cik ade rase sakit mane mane?
● Palpate the skin around the stoma with two fingers for
tenderness (infection parastomal abscess)
● Palpate the stoma to see contact bleeding
● Put gel and insert little fingers into the lumen to confirm whether
● Any stenosis
● Auscultation
2. What is a stoma?
3. Not only for drainage and diverting, stoma can also be an input port eg
● According to design
● End colostomy
● Loop colostomy
● Based on function
● Temporary
● Double barrel colostomy
● Loop colostomy
● Permanent
5. Cecum, transverse colon and sigmoid colon are mobile so suitable to have
stoma
● Ascending and descending colon are not suitable because they are
6. If a stoma located at left iliac fossa, but spouting of mucosa, with a laparotomy
scar?
colorectal Ca)
A loop of colon is brought to the surface of the body and may be supported by a rod
which is removed after about 5 days. The bowel wall is partially cut to produce 2
openings (afferent and efferent limb). The afferent limb leads to functioning part of
the colon (which stool and gas pass out) and the efferent limb leads to
non-functioning part of the colon.
**Ileo-colic anastomosis usually won’t need covering stoma because small bowel
has rich blood supply → faster healing → less risk of anastomotic risk. However,
anastomosis btw large bowel usually needs covering stoma because large bowel
● Permanent
Adenomatous Polyposis)
● Hirschsprung disease
● Total colonic 5%
● Imperforate anus
immediately
● Adult
● Hartmann procedure
● IO to divert faeces
● Permanent stoma
● APR
● Rehabilitation patient
● Advanced ca
● Immobilize patient
● Stoma gangrene
● Stenosed stoma
● Late complication
● Parastomal hernia
defunctioning stoma?
● For colocolic anastomosis, a covering/defunctioning stoma is done
intestine
● So give time for healing