[The stoma in peritonitis and pancreatitis]

Today, there are 3 indications for a stoma in peritonitis and pancreatitis: 1) A defunctioning loop ileostomy to protect the anastomosis of the colon in case of intra-abdominal sepsis. 2) A proximal colostomy after resection of the perforated distal colon and closure of the rectal stump in case of severe generalized peritonitis without the possibility to perform a primary anastomosis and 3) a loop ileostomy to prevent bacterial translocation in case of pancreatitis. After having eliminated the source of infection, the surgeon is able to create a convenient starting-point for further therapy of the intra-abdominal sepsis through a stoma. The most favorable prognosis is attested to patients of group 1): Only 2 out of 9 patients with intraabdominal sepsis died. In contrast, patients of group 2) with severe generalized peritonitis had a mortality of 59% (13/22). At this time, it is not possible to give any certain results about patients of group 3) because of an ongoing study.