Colostomy for large bowel anomalies in children: a case controlled study

Area of Science:

• Pediatric surgery
• Gastroenterology
• Surgical complications

Background:

• Colostomy is a critical treatment for congenital large bowel anomalies in children.
• This procedure is frequently associated with significant complications.
• A review of colostomy morbidity and mortality in southeast Nigeria was conducted.

Purpose of the Study:

• To review the morbidity and mortality associated with colostomy formation and closure in children.
• To analyze complications related to colostomy for large bowel anomalies over a 10-year period.
• To identify factors influencing complication rates and outcomes.

Main Methods:

• Retrospective evaluation of 182 colostomies and 146 colostomy closures.
• Data collected from children treated at the University of Nigeria Teaching Hospital Enugu.
• Study period: January 1995 to December 2004.

Main Results:

• Hirschsprung's disease and anorectal malformation were primary indications for colostomy.
• A high complication rate of 43.4% was observed, with skin excoriation and prolapse being most common.
• Loop colostomy had a higher complication rate than defunctioning colostomy (P<0.001); mortality was 1.6%.

Conclusions:

• Late construction of colostomies for large bowel anomalies is common, linked to delayed presentation.
• Delayed presentation, particularly in Hirschsprung's disease, may increase morbidity.
• Loop colostomy should be used less frequently due to its higher complication rate.