A novel, easy, non-operative method of treating prolapsed colostomy

Colostomy prolapse is a major cause of morbidity in paediatric patients with Hirschsprung's disease and anorectal malformations. Although it is commonly associated with the distal loop of a transverse colostomy, a sigmoid stoma can also be affected. We report six babies with anorectal malformations between day 10 and 6 months presenting with incessant crying and irritability following prolapsed colostomy stomas. In four patients only the distal stomas were involved but in the other two both proximal as well as distal loops had prolapsed. All the babies had poor oral intake and had bleeding from the prolapsed stomas. Manual reposition with sedation did not help. After reducing the prolapsed part a no. 7 or 7.5F Romsons tracheostomy tube was introduced through the stoma. A cotton tap (16-mm wide) was tied to the flanges of the tracheostomy tube and fastened around the flank for proper fixation. None of the babies had further prolapse and were passing stool through the tube. The tubes were kept for an average period of 4(1/2) (3-9(1/2)) months. Only one patient had frequent displacement of the tube, which the mother learned to reposition without any other problems. We feel that this non-operative simple procedure can be used for treatment of massive colostomy prolapse without any complications. Parents can learn this procedure easily thus avoiding frequent hospitalisation and other invasive procedures.