Colostomy in Children: Indications and Complications

Objective: To determine the indication and frequency of complications occurring with construction of colostomy in children. Methodology: This descriptive study was conducted at Paediatric Surgery department of PMC Hospital and at Mumtaz Medical Center (Pvt.) Nawab Shah, from April 2008 to December 2009. All patients who required colostomy as the part of management were included in this study. The patients who were operated upon previously or elsewhere and were referred after having colostomy, were excluded. In all patients loop colostomy was performed. Complications after colostomy construction were noted on a proforma. Results: Thirty- seven colostomies were created in 36 patients. Sigmoid loop colostomies were 51.35%, Right and left transverse colostomies in 24.32% each. All patients were operated due to congenital anomalies. Twenty-eight patients had anorectal malformation and 8 Hirschsprung’s disease. Common Complications related to stoma were excoriation of skin 58.82% and prolapse of stoma (50%). Anaemia due to chronic blood loss was seen in 53.33% of patients. Transverse loop colostomy had higher number of complications / problems as compared with sigmoid loop colostomy. Five (13.88%) patients died (Three because of septicaemiae, one because of high grade fever at home, and one died on 2 nd of PSARP, the cause could not be ascertained. Conclusion: Construction of colostomy in paediatric patients carries high frequency of complications and requires careful technique. A sigmoid loop colostomy is an ideal as it has minimal complications. Stoma care clinic and enterostomal therapist can be helpful in educating families for stoma care and to decrease the incidence of complications.