Prevalence of Intestinal Stoma Formation in the Management of Abdominal Surgery in Emergency Department of Allama Iqbal Memorial Teaching Hospital

Aim: To determine theprevalence of stoma formation during abdominal surgical procedures in emergency setting for all the indications in Allama Iqbal Memorial Teaching Hospital, Sialkot Study Design: Prospective analytical. Place & duration of study: Department of Surgery, Allama Iqbal Memorial Teaching Hospital affiliated to Khawaja Muhammad Safdar Medical College, Sialkot; from December 2012 to January2016. Methodology: All patients of abdominal surgeries operated within 24 hours/ same day of presentation in emergency departmentwere included irrespective of age, presentation and co-morbid pathologies. Patients with known history of malignancies were also included. The surgeries were done by the experiencedsurgeons not below the rank of senior registrars. The patients without 3 months follow up were excluded from the study. Results: Total of 2243 abdominal surgeries were carried out, 107 patients fulfilling the inclusion criteria;had a stoma either in small intestine or large intestine. Infections and secondary perforations leading to 33(30.84%) ileostomies/ Exteriorization of perforationwere the main pathology; while skin excoriation 19(25.33%)and retraction 5(6.66%) were the complications in small bowel stomas and parastomal hernia 3(4.00%) encountered in colostomies. Psychological 12(16.00%) and social problems 9(12.00%) like depression and dissolution of marriage also was quite worrisome. We had 3 mortalities due to septicaemia and patients reporting in late stage. Conclusion: Stoma formation is a life-saving surgical procedure. It has profound effect on outcome and is a major salvage procedure in protecting the life of patients in emergency setting. These procedures definitely have significant morbidity. All the surgeons must be well trained in these procedures to minimize complications associated with stoma formation.