Morbidity and mortality of colostomy and its closure in children
Section snippets
Colostomy
One hundred forty-six colostomies were performed during the study period (January 1992 to June 1999) in the pediatric surgery unit of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India. The youngest was a day-old newborn, and the eldest was 12 years of age, the latter being a patient with posttraumatic complete perineal tear. The various indications of colostomy, performed during the study, are shown in Fig 1. The different types of colostomies
Mortality
There were 2 deaths (1.4%). Only 1 (0.7%) was directly related to the performance of colostomy; he had peristomal subcutaneous emphysema caused by synergistic gangrene and died of septicemia. The other child died of cyanotic heart disease, which was associated with imperforate anus, dextrocardia, and Turner’s syndrome.
Early complications
There were 22 early complications. Three patients who presented with intestinal obstruction had pericolostomy hernia (2.1%). The hernia was reduced, and the rectus defect was
Discussion
Mortality caused by the performance of colostomy is rare and varies from 0% to 9.5%.5, 6, 7, 8 It is predominantly owing to the associated cardiac anomalies. Morbidity (Table 1) owing to colostomy has changed very little over the last 2 decades.1, 5, 9, 10 Nutritional aspect associated with colostomy, which was widely reported initially,11 lost its importance later, and malnutrition has resurged as an important complication (23.9%) in the current study. In spite of the initial speculation
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