ISSN 2398-2977      

Colostomy

pequis

Introduction

  • To allow temporary or permanent (less common) diversion of the fecal mass from the rectum to a stoma created within the abdominal wall in the flank.
  • Usually this is to enable a rectal tear to heal by second intention or to rest a primary closure.
  • Temporary colostomy is repaired after the rectal injury has healed.
  • Alternatively, this is permanent when a distal section of the small colon is non-viable due to mesenteric rupture, eg during/after parturition.

Uses

  • Temporary or permanent diversion of fecal material from the rectum/distal colon to permit healing of damage in these areas without impaction and additional contamination, eg rectal tears Rectum: tear.

Indications

  • Rectal tears Rectum: tear.
  • Rectal neoplasia.
  • Tearing of small colon mesentery leading to non-viable distal small colon with or without rectal/small colon prolapse (intra/post-parturition).

Advantages

Disadvantages

  • Cost of surgery and post-operative care.
  • Requires second surgery to restore rectal continuity (where temporary).
  • End colostomy is more difficult to perform and reverse than a loop colostomy.
  • The stoma created using the single incision technique is predisposed to peristomal herniation and stomal prolapse because the incision in the body wall muscle weakens it (in the double incision technique, intact muscle layers surround and support the stoma).

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Guarded to grave for survival: depends on severity of rectal tear and immediate first aid treatment.
  • Guarded: colostomy.
  • If permanent colostomy performed on a broodmare, palpation of the ovaries may not be possible for following ovulation for insemination.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Espinosa Buschiazzo C A, Cancela C J & Simian M V (2010) Permanent colostomy after small colon prolapse in a parturient mare. Equine Vet Educ 22 (5), 223-227 VetMedResource.
  • Schumacher J (1999) Rectal tears of horses. Equine Vet Educ 11 (1), 23-28 VetMedResource.
  • Freeman D E et al (1992) Loop colostomy for management of rectal tears and small-colon injuries in the horse - 10 cases (1976-1989). JAVMA 200, 1365-1371 PubMed.

Other sources of information

  • Freeman D E (2012) Rectum and Anus. In: Equine Surgery. 4th edn. Eds: Auer J A & Stick J A. W B Saunders, USA. pp 494-505.

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