Ostomy Complications: A Narrative Review for Emergency Clinicians

An ostomy is a surgical opening between a hollow organ and the body surface. These are necessary for several conditions, but complications may arise following ostomy creation.

This narrative review provides emergency clinicians with a focused overview of ostomy complications.

An ostomy is a diverting measure for management of several conditions, including gastrointestinal malignancy, inflammatory bowel disease, bowel obstruction, perforation, and trauma, and in pediatric patients, other indications include bowel malformations, Hirschsprung's disease, and necrotizing enterocolitis. Ileostomies connect the small bowel to the skin surface and are typically on the right side of the abdomen with a smaller stoma, while colostomies connect the large bowel to the skin and are typically on the left side with a larger stoma. A number of complications may occur, most commonly within the first 5 years after ostomy creation. Early complications include high-output, stoma necrosis, stoma retraction, and skin irritation/dermatitis, while later complications include parastomal hernia, stomal prolapse, stomal stenosis, and bleeding. Surgical consultation is recommended for many of these complications. Emergent surgical intervention may be necessary in those with stoma necrosis and parastomal hernia with strangulated bowel, as well as those with obstruction.

An understanding of ostomy complications can assist emergency clinicians.