Use an Empty Lab Tube to Check the Viability of a Stoma
B. Robert Gibson MD
While stoma placement is typically considered a minor procedure, complications following it are frequent and potentially devastating. The complication rate has been reported to vary from 25% following colostomy to 75% following end ileostomy. These complications include retraction, prolapse, hernia, fistula, ulceration, stenosis, bleeding, and necrosis.
Stomal ischemia is more common with end stomas than with loop stomas. Causes of compromised blood flow are varied and usually related to surgical technique around the time of stoma formation. A too-tight abdominal stoma site may cause extrinsic compression of the blood vessels feeding the distal bowel. Tension on the vascular pedicle due to progressive abdominal distention or inadequate mobilization may lead to progressive ischemia of the stoma. Excessive intraoperative dissection of the bowel mesentery can lead to compromised distal arterial blood supply. Blood vessels may also become kinked as the bowel mesentery traverses the abdominal wall.