Fibrinopurulent segmental colitis in ostomas

Abstract

A prospective and retrospective study was carried out at the Caja Nacional de Salud in the city of Cochabamba between January 1999 and May 2009, studying 185 cases of colon surgery with colostomies, of which 112 cases (60.5%) corresponded to the Hartmann type, 35 cases (19%) to cecostomies, 28 cases (15.1%) to Wangensteen and 10 cases (5.4%) to Miles. As for morbidity due to surgical procedures, we found: edema, chemical dermatitis, bleeding, pericolostomy abscess, retraction of the mouth, partial and total necrosis, stenosis, partial and total detachment, eventration, internal hernias, prolapse, fistulas, perforations, evisceration and psychological diseases, which are frequent complications of colostomies.

We incidentally found 3 cases (1.6%) of segmental fibrinous-purulent colitis in Wangensteen transversostomies and this type of complication was not found in all the literature reviewed. Two cases were treated with resection and end-terminal anastomosis and one case only with resection of the fibrotic edges and reconstruction, we believe that this type of complication can occur in other colostomies and its cause is an over infection due to poor management of the ostoma. Because of this rarity, we consider that fibrinopurulent segmental colitis should be taken into account within the morbidity of colostomies. Finally, there was mortality in three cases (1.6%) due to total detachment of the Hartmann's ostomy due to sepsis and stercoraceous peritonitis.