Frequency of Complications in Patients Undergoing Temporary Ileostomy at a  Tertiary Care Hospital

Sajid Ali; Hamza Shakeel; Saadan Saleem; Sohaib Ashraf; Abdur Rehman Rashid; Muhammad Saqlain

doi:10.51253/pafmj.v76i5.14091

Authors

Sajid Ali Department of General Surgery, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
Hamza Shakeel Department of General Surgery, Combined Military Hospital, Kohat/National University of Medical Sciences (NUMS) Pakistan
Saadan Saleem Department of General Surgery, Combined Military Hospital, Tarbela /National University of Medical Sciences (NUMS) Pakistan
Sohaib Ashraf Department of General Surgery, FC Hospital, Peshawar Pakistan
Abdur Rehman Rashid Department of General Surgery, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
Muhammad Saqlain Department of General Surgery, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i5.14091

Keywords:

Hemorrhage, Ileostomy, Surgical Site Infection, Surgical Stoma.

Abstract

Objective: To determine the frequency of complications in patients undergoing temporary ileostomy.

Study Design: Prospective observational study.

Place & Duration of Study: Department of Surgery, Combined Military Hospitals, Rawalpindi and Peshawar, Pakistan, from Oct 2022 to Sep 2025.

Methodology: A total of 295 patients, aged 13 to 80 years, undergoing temporary ileostomy were included, regardless of gender. Patients with a history of prior abdominal surgeries or metastatic colorectal malignancies were excluded. Postoperatively, patients were monitored during their hospital stay, with initial assessment on the first postoperative day to detect hemorrhage and stomal necrosis. A subsequent evaluation on the seventh postoperative day was conducted to identify complications such as retraction, stenosis, prolapse, and high-output fistula. Thereafter, patients were followed in the outpatient department at 15-day intervals for a period of three months or until stoma reversal, to document any delayed complications.

Results: The frequency of complications among patients undergoing temporary ileostomy was as follows: surgical site infection (SSI) occurred in 45 patients (15.25%), peristomal skin changes in 33(11.19%), stoma prolapse in 37(12.54%), bleeding in 19(6.44%), necrosis in 21(7.12%), retraction in 24(8.14%), and high-output fistula in 8 patients (2.71%).

Conclusion: Surgical site infection emerged as the most frequently encountered complication in patients undergoing temporary ileostomy.

Downloads

Download data is not yet available.

References

1. Belén MG, Rivas GN, Santos BT, María L, José MJ, Natán RP, et al. Changes in the quality of life of adults with an ostomy during the first year after surgery as part of the Best Practice Spotlight Organisation® Programme. Int Wound J 2023; 21(3): e14456.

https://dx.doi.org/10.1111/iwj.14456

2. Neelam H, Hussain M, Afzal M, Gilani SA. Knowledge and practices of stoma care among patients at tertiary care hospital Lahore Pakistan. J Health Med Nurs 2020; 74: 145-177.

https://dx.doi.org/10.7176/JHMN/74-10

3. Din SK, Yaqoob A, Perveen K, Khan S. Knowledge of Patients Regarding Self Care Practice with Permanent Colostomy in a Tertiary Care Hospital in Lahore, Pakistan. Pak J Med Health Sci 2022; 16(2): 299-301. https://doi.org/10.53350/pjmhs22162299

4. Toffaha A, Badr A, Al-Dhaheri M. Risk factors for stoma outlet obstruction: systematic review and meta-analysis. Langenbecks Arch Surg 2025; 410: 317.

https://doi.org/10.1007/s00423-025-03892-5

5. Sciuto A, Merola G, De Palma GD, Sodo M, Pirozzi F, Bracale UM, et al. Predictive factors for anastomotic leakage after laparoscopic colorectal surgery. World J Gastroenterol 2022; 24(21): 2247-2260.

https://doi.org/10.3748/wjg.v24.i21.2247

6. Pandiaraja J, Chakkarapani R, Arumugam S. A study on patterns, indications, and complications of an enteric stoma. J Family Med Prim Care 2021; 10(9): 3277-3282.

https://doi.org/10.4103/jfmpc.jfmpc_123_21

7. Swathi KN, Thomas M, Kapil A, Saigal K, Ray P, Shalini A, et al. Ileal Perforation and Enteric Fever: Implications for Burden of Disease Estimation. J Infect Dis 2021; 224(5): 522-528.

https://doi.org/10.1093/infdis/jiab258

8. Schiergens TS, Hoffmann V, Schobel TN. Long-term quality of life of patients with permanent end ileostomy: results of a nationwide cross-sectional survey. Dis Colon Rectum 2022; 60: 51–60. https://doi.org/10.1097/DCR.0000000000000732

9. Malik T, Lee MJ, Harikrishnan AB. The incidence of stoma related morbidity - a systematic review of randomised controlled trials. Ann R Coll Surg Engl 2022; 100(7): 501-508.

https://doi.org/10.1308/rcsann.2018.0126

10. Parini D, Bondurri A, Ferrara F, Rizzo G, Pata F, Veltri M, et al. Surgical management of ostomy complications: a MISSTO–WSES mapping review. World J Emer Surg 2023; 18(1): 48.

https://doi.org/10.1186/s13017-023-00516-5

11. Formijne JHA, Draaisma WA, Roskott AM, van Overbeeke AJ, Broeders IA, Consten EC. Early complications after stoma formation: a prospective cohort study in 100 patients with 1-year follow-up. Int J Color Dis 2022; 27: 1095–1099.

https://doi.org/10.1007/s00384-012-1413-y

12. Raza A, Talpur AA, Khatti SN, Agha AH, Rizvi MB, Ahmad Z. Utility of Distal Loopogram Prior to Post Typhoid Ileostomy Reversal: Distal Loopogram for Typhoid Ileostomy Reversal. Pak J Health Sci 2024: 151-155.

https://doi.org/10.54393/pjhs.v5i04.1511

13. Shar ZA, Hussain Z, ud Din S, Ahmed I, Ali F, Memon AH. Evaluation of the Causal Factors of Complications Following Ileostomy Closure: Causal Factors of complications following ileostomy closure. Pak BioMed J 2022: 79-83.

https://doi.org/10.54393/pbmj.v5i5.444

14. Anderson CB, McKiernan JM. Surgical complications after urinary diversion. Urol Clin North Am 2023; 45: 79–90.

https://doi.org/10.1016/j.ucl.2017.09.008

15. Krishnamurty DM, Blatnik J, Mutch M. Stoma complications. Clin Colon Rectal Surg 2017; 30: 193–200.

https://doi.org/10.1055/s-0037-1598160

16. Tsujinaka S, Tan KY, Miyakura Y. Current management of intestinal stomas and their complications. J Anus Rectum Colon 2020; 4(1): 25–33.

https://doi.org/10.23922/jarc.2019-032

17. Ohira G, Miyauchi H, Hayano K. Incidence and risk factor of outlet obstruction after construction of ileostomy. J Anus Rectum Colon 2023; 2(1): 25–30.

https://doi.org/10.23922/jarc.2017-034

18. D’Ambrosio F, Pappalardo C, Scardigno A, Maida A, Ricciardi R, Calabrò GE et al. Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective. Int J Environ Res Public Health 2022; 20(1): 79. https://doi.org/10.3390/ijerph20010079

19. Duarte F, Elisabete L, Paulo J. Ileostomy: Early and Late Complications. J Coloproctol 2024; 44(01): e80–86.

https://doi.org/10.1055/s-0044-1779603

20. Latif A, Shabbir F, Hameed K. Prevalence of Intestinal Stoma Formation in the Management of Abdominal Surgery in Emergency Department of Allama Iqbal Memorial Teaching Hospital. Pak J Med Health Sci 2016; 10(2): 498-502.