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Loop colostomies are totally diverting in adults
1Department of Surgery, Louisiana State University Medical Center, Shreveport.
American Journal of Surgery
|June 1, 1991
Summary
Loop colostomies, used for colon injuries, are fully diverting. This study found no barium passage into the distal colon, supporting their use over divided colostomies for fecal diversion.
Area of Science:
- Colorectal Surgery
- Surgical Anatomy
- Gastrointestinal Tract
Background:
- Temporary colostomies are crucial for managing colon injuries.
- Current surgical teaching suggests loop colostomies may not be completely diverting.
Purpose of the Study:
- To investigate the complete fecal diversion capability of loop colostomies.
- To compare the efficacy of loop colostomies versus divided colostomies.
Main Methods:
- Twenty-three patients undergoing loop colostomy closure received oral barium.
- Serial abdominal radiography was performed over 24 hours.
- Post-bowel preparation imaging assessed distal barium passage.
Main Results:
- No barium passage into the distal limb of the colon was observed in any patient.
- This finding held true even for long-standing loop colostomies.
- Bowel preparation did not induce distal barium transit.
Conclusions:
- Loop colostomies, particularly those matured immediately over a rod, provide complete fecal diversion.
- The study supports the abandonment of divided colostomies when loop colostomies are feasible.
- Loop colostomies offer advantages in ease and speed of creation and closure.
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