Evaluation of Complications of Colostomy in Children

Abstract

Background and Aims This study aimed to evaluate the complications of colostomy and its management in children at tertiary care centre.Methods This descriptive observational study was conducted over a period of four years from February 2017 to January 2021. All the children below five years of age who underwent colostomy were included in the study. The demographic and clinical data on age at colostomy procedure sex clinical details indication for colostomy site type of colostomy complications of colostomy procedure morbidity and mortality due to the colostomy procedure were collected and analyzed.Results During our study period 38 children underwent colostomy procedure who had fulfilled our inclusion criteria. Among 38 children 23 60.5 children were of High Anorectal Malformations and 15 39.5 children were of Hirschsprungrsquos disease. Children who had anorectal malformation were younger and underwent colostomy in neonatal period mean 3 days plusmn 2.41 compared to those who had Hirschsprungrsquos disease who underwent colostomy procedure between one month to five years mean 6.8 months plusmn 3.55. There were 26 60.4 male and 12 31.6 female children with male to female ratio of 2.21. Complications related to colostomy procedure were seen in 28 73.7 children. Early complications like wound infection superficial wound dehiscence stoma necrosis and bleeding stoma were seen in 13 34.2 children whereas late complications like Peristomal skin excoriation Colostomy retraction Colostomy stenosis Colostomy prolapse Para colostomy hernia were seen in 15 39.5 children. Majority of complications 17 44.7 were seen in end colostomy made in Hirschsprungrsquos disease children. Systemic complications like sepsis pneumonitis was seen in early post-operative period in 8 21.1 children among which two 5.3 children succumbed due to severe sepsis and respiratory failure.Conclusions Although colostomy complications are common in children majority of the colostomy complications are prevented or minimized by good surgical technique education of parents on colostomy care and hygiene.