Enterostomy

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An enterostomy ( entero- + -stomy ; /ɛntəˈrɒstmi/ ) is either (1) a surgical procedure to create a durable opening (called a stoma) through the abdominal wall into an intestine (small intestine or large intestine) or (2) the stoma thus created. The various types of enterostomy are named according to which intestinal segment is involved.

Surgery Medical specialty

Surgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas.

In anatomy, a stoma is any opening in the body. For example, a mouth, a nose, and an anus are natural stomata. Any hollow organ can be manipulated into an artificial stoma as necessary. This includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, urinary bladder, and renal pelvis. Such a stoma may be permanent or temporary. Surgical procedures that involve the creation of an artificial stoma have names that typically end with the suffix "-ostomy", and the same names are also often used to refer to the stoma thus created. For example, the word "colostomy" often refers either to an artificial anus or the procedure that creates one. Accordingly, it is not unusual for a stoma to be called an ostomy, as is the norm in wound, ostomy, and continence nursing.

Abdominal wall represents the boundaries of the abdominal cavity

In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the posterior (back), lateral (sides) and anterior (front) walls.

Enterostomy typeIntestinal segment
duodenostomy duodenum
jejunostomy jejunum
ileostomy ileum
cecostomy cecum
appendicostomy appendix
colostomy colon

Indications for surgery and complications are dependent on the site of the enterostomy. [1]

Gastrostomies and enterostomies can be used to provide nutrition in digestive disorders. [2]

Hernia development at both permanent and temporary enterostomy sites in a common complication. [3]

See also

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Fistula abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs

A fistula is an abnormal connection between two hollow spaces, such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injury or surgery, but they can also result from an infection or inflammation. Fistulas are generally a disease condition, but they may be surgically created for therapeutic reasons.

Feeding tube

A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units. They are classified by the site of insertion and intended use.

Colostomy surgical procedure in which a hole is cut into the colon and stoma is placed

A colostomy is an opening (stoma) in the large intestine (colon), or the surgical procedure that creates one. The opening is formed by drawing the healthy end of the colon through an incision in the anterior abdominal wall and suturing it into place. This opening, often in conjunction with an attached stoma appliance, provides an alternative channel for feces to leave the body. Thus if the natural anus is not available for that job, an artificial anus takes over. It may be reversible or irreversible, depending on the circumstances.

Percutaneous endoscopic gastrostomy type of gastrostomy in which a tube is passed into the stomach through the abdominal wall

Percutaneous endoscopic gastrostomy (PEG) is an endoscopic medical procedure in which a tube is passed into a patient's stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. This provides enteral nutrition despite bypassing the mouth; enteral nutrition is generally preferable to parenteral nutrition. The PEG procedure is an alternative to open surgical gastrostomy insertion, and does not require a general anesthetic; mild sedation is typically used. PEG tubes may also be extended into the small intestine by passing a jejunal extension tube through the PEG tube and into the jejunum via the pylorus.

Short bowel syndrome Human disease

Short bowel syndrome is a malabsorption disorder caused by a lack of functional small intestine. The primary symptom is diarrhea, which can result in dehydration, malnutrition, and weight loss. Other symptoms may include bloating, heartburn, feeling tired, lactose intolerance, and foul-smelling stool. Complications can include anemia and kidney stones.

Ileostomy surgical procedure that creates a long-term opening in the end of the small intestine (ileum)

Ileostomy is a stoma constructed by bringing the end or loop of small intestine out onto the surface of the skin, or the surgical procedure which creates this opening. Intestinal waste passes out of the ileostomy and is collected in an artificial external pouching system which is adhered to the skin. Ileostomies are usually sited above the groin on the right hand side of the abdomen.

In medicine, the ileal pouch–anal anastomosis (IPAA), also known as an ileo-anal pouch, restorative proctocolectomy, ileal-anal pullthrough, or sometimes referred to as a j-pouch, s-pouch, w-pouch or an internal pouch, is an anastomosis of the ileum to the anus, bypassing the former site of the colon in cases where the colon has been removed. It retains or restores functionality of the anus, with stools passed under voluntary control of the patient, preventing fecal incontinence and serving as an alternative to ileostomy. The pouch component is a surgically constructed intestinal reservoir; usually situated near where the rectum would normally be. It is formed by folding loops of small intestine back on themselves and stitching or stapling them together. The internal walls are then removed thus forming a reservoir. The reservoir is then stitched or stapled into the perineum where the rectum was.

Gastrostomy surgical procedure in which a long-term hole is cut into the stomach

Gastrostomy is the creation of an artificial external opening into the stomach for nutritional support or gastric decompression. Typically this would include an incision in the patient's epigastrium as part of a formal operation. It can be performed through surgical approach, percutaneous approach by interventional radiology, or percutaneous endoscopic gastrostomy (PEG).

Cystectomy

Cystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer.

Urostomy surgical procedure that creates a long term opening in the urinary system

A urostomy is a surgical procedure that creates a stoma for the urinary system. A urostomy is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible, e.g. after extensive surgery or in case of obstruction.

Urinary diversion is any one of several surgical procedures to reroute urine flow from its normal pathway. It may be necessary for diseased or defective ureters, bladder or urethra, either temporarily or permanently. Some diversions result in a stoma.

Bariatric surgery includes a variety of procedures performed on people who have obesity. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach or by resecting and re-routing the small intestine to a small stomach pouch.

Ureterostomy surgical procedure that creates a long-term opening for a ureter or kidney

A ureterostomy is the creation of a stoma for a ureter or kidney.

Urethrostomy a surgical creation of an artificial opening from the male urethra to the perineum

Urethrostomy is a surgical procedure that creates a permanent opening in the urethra, commonly to remove obstructions to urine flow. The procedure is most often performed in male cats, where the opening is made in the perineum.

Jejunostomy surgical procedure that cuts a long-term hole into the jejunum through the abdomen

Jejunostomy is the surgical creation of an opening (stoma) through the skin at the front of the abdomen and the wall of the jejunum. It can be performed either endoscopically, or with formal surgery.

Enterotomy is the surgical incision into an intestine. It may be purposeful or a complication of an abdominal surgery, such as exploratory laparotomies or hernia repair.

Intercostal nerve block

Intercostal nerve block is a nerve block which temporarily or permanently interrupts the flow of signals along an intercostal nerve, usually performed to relieve pain.

Nils G. Kock was a Professor of Surgery who taught and practiced at the University of Gothenburg, Gothenburg, Sweden. Kock was noted for his research, experimentation, and colorectal surgical techniques. These led to his breakthrough development of the Kock pouch, used for people who require excretory stomas.

References

  1. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care (7 ed.). Elsevier. 2019. pp. 828–851.
  2. Braddom's Physical Medicine and Rehabilitation (5 ed.). Elsevier. 2015. pp. 449–468.
  3. Current Therapy in Colon and Rectal Surgery (3 ed.). Elsevier. 2017. pp. 496–500.