Enterostomy

The intestines are usually cleaned out with a cathartic solution prior to surgery. Anesthesia General anesthesia is administered. A gastrostomy is usually performed under sedation and local anesthesia. Description of the Procedure There are multiple variations of enterostomy. In some versions, an intestinal sac for collecting fecal waste is created inside the abdomen, with a stoma (hole) in the abdominal wall to access and empty the sac. Other versions of enterostomy attach the intestine directly to the abdominal wall so that an external bag can be attached to collect fecal waste. These procedures may be performed either by a direct abdominal incision, or by laparoscopy . In a tube gastrostomy, a hole is made in the stomach so that a feeding tube can be inserted and allow for nutrients to be directly administered into the stomach cavity. Feeding Tube 2008 Nucleus Medical Art, Inc. After Procedure Recovery from this major surgery takes some time, and regular intestinal function may not be restored for several days. How Long Will It Take? Typically insertion of a tube takes between 30-45 minutes. If sections of the intestine need to be removed as well, it may take 2-4 hours. Will It Hurt? Because anesthesia is administered during the procedure, it is painless. Some soreness and tenderness following the procedure is normal, but can be controlled with pain medication.

Possible Complications Possible complications of enterostomy include: Skin irritation around the stoma from leaking digestive fluids Diarrhea Abscesses Gallstones or stones in the urinary tract Inflammation of the ileum Intestinal obstruction Section of the bowel protruding from the body (hernia) Blockage or leakage of the tube, requiring replacement Average Hospital Stay The average hospital stay is 1-3 nights. Postoperative Care Proper care of the incision site is required to prevent infection. Because there is greater risk of dehydration in some patients who have undergone enterostomy, fluid intake and output is regularly monitored. Outcome Prognosis is good, with approximately 95% of patients experiencing a full recovery. Call Your Doctor If Any of the Following Occurs Redness, soreness, or swelling occurs at the incision site High fever Pus, or yellow/green discharge from the incision Food cannot pass through the tube The tube comes out or leaks RESOURCES: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/index.htm University of Michigan Health System

http://www.med.umich.edu CANADIAN RESOURCES: The Canadian Association of Gastroenterology (CAG) http://www.cag-acg.org/default.aspx Canadian Digestive Health Foundation http://www.cdhf.ca/aboutcdhf.htm References: Shellito PC, Malt RA. Tube gastrostomy. Techniques and complications. Ann Surg . 1985;201(2):180-185. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1250638 . Accessed March 9, 2007. Torosian MH, Rombeau JL. Feeding by tube enterostomy. Surg Gynecol Obstet . 1980;150(6):918-927. Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6769170&dopt=Abstract . Accessed March 9, 2007. US Food and Drug Administration, April 2006, Chapter H, Medical Devices. US Food and Drug Administration website. Available at: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?FR=876.5980 . Last reviewed March 2008 by Ronald Nath, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.