ABSTRACT
Intestinal stomas are an unfortunate but frequently a necessary outcome of intestinal surgery. This often life-preserving intervention is actually a trick that surgeons have plagiarised from the evolutionary catalog that allowed our ancestors to survive abdominal catastrophe through spontaneous enterocutaneous fistula formation. The basic principle of stoma formation is the delivery of an end or loop of open intestine through a full thickness defect in the abdominal wall. Maturation of the mucocutaneous junction with sutures then follows to facilitate healing. Although not always possible, patients who are likely to require stoma formation should be referred to a specialised ostomy care practitioner. This will help address the practicalities of marking an appropriate stoma site. It is useful to consider stoma position in the context of the patient’s life circumstances and dynamic anatomy. Stomas can in theory be formed from any part of the gastrointestinal tract, and include oesophagostomy, gastrostomy, jejunostomy, ileostomy, appendicostomy, caecostomy and colostomy.
