Abstract
A modification of the simplified colostomy stapler technique of Photopulos, et al. is presented whereby no colonic mucous fistula is created when no distal rectal obstruction is present. A case is reported in which lethal peritonitis developed subsequent to small bowel infarction and perforation following internal herniation of the small bowel lateral to the colostomy site. Placement of permanent sutures to affix the proximal colon to the lateral gutter peritoneum at the time of formation of the colostomy is recommended to avert this complication.
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