A lady, post-colostomy closure after 4days comes with fluctuating small swelling in the stoma.
What is the management option for her?
a. Local exploration
b. Exploratory laparotomy
c. Open laparotomy
d. Reassure
answer: A : fluctuation indicates an abscess has formed
Complications of Stoma
Stomal abscess: local collection of pus, drainage/antibiotics
Peristomal hernia
- Peristomal bulge, can change in size as the patient stands or sits
- If uncomplicated, supportive treatment
Prolapse
- bowel prolapsed into stoma, supportive/surgery if complicated
Laceration
- Supportive treatment, unless complicated
Seperation of stoma from skin
- Surgery only if below the level of the fascia
Necrosis
- Dark red, purplish, dusky blue (cyanotic tint), gray, brown, or black
- Surgery if below the level of the fascia
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