**Abstract**

The management of patients submitted to intestinal stomas (ileostomy or colostomy) and description of the routine care and main complications are the scope of the chapter. The impact of the stoma on patients' daily life with a functional list of capabilities they can exert with security and illustrations of the commonest drawbacks are also discussed. A series of pictures showing the most commonly occurring complications depicted in the section Problems and complications help to a better understanding of the author's intended message. Finally in the "References" topic, it was tried to cite society-based guidelines and review papers concerning ostomy care and complications.

**Keywords:** colostomy and ileostomy management, complications, peristomal hernia, prolapse, retraction, necrosis

## **1. Introduction**

An ostomy is a surgically created opening between a hollow organ and the body surface or between two hollow organs. The surgical interventions which result in ostomies are based on the need to modify the natural way of ingestion of food or excretion of waste products. The word *ostomy* comes from the Latin word *ostium*, meaning mouth or opening, plus the suffix -*tomy*, implying a surgical or injury state. The word *stoma* comes from the Greek word for mouth and is used interchangeably with ostomy.

Depending on the organ involved, an ostomy is further characterized by adding the name of the organ involved: gastrostomy to indicate an opening from the stomach to the skin, an ileostomy from the ileum to the skin, and a colostomy from the colon. In addition an anastomosis between the small bowel and colon is called *ileocolostomy*; between sigmoid colon and the rectum, a *sigmoidorectostomy*; and between the stomach and the jejunum, a *gastrojejunostomy*. A loop ostomy is built by bringing a loop of bowel through the skin and then dividing the antimesenteric border and maturing it so that there are two open lumens, the proximal and the distal.

An ostomy can be created virtually anywhere along the gastrointestinal tract. For diversion of the fecal stream, the most common ostomies involve the distal small intestine (ileostomy) and large intestine (colostomy).

Temporary or permanent fecal diversions by the creation of an ostomy, which is a purposeful anastomosis between a segment of the gastrointestinal tract and the skin of the anterior abdominal wall, may be needed to manage a variety of

pathologic conditions, including congenital anomalies, colon obstruction, inflammatory bowel disease, traumatic disruption of the intestinal tract, or gastrointestinal malignancy, when restoration of intestinal continuity is contraindicated or not immediately feasible given the patient's clinical condition. End ostomy is the name indicative of a hollow viscera pull to the skin as a terminal opening. In this way only one open lumen is viewed. The majority of ostomies today are created as a temporary measure, although the ostomies with a permanent intention are not rare. Construction of an ostomy should always be performed using a segment of healthy, well-vascularized bowel. Expected difficulties arise in morbidly obese patients or those with extensive adhesions.

This chapter will discuss ostomies brought to the surface of the body, focusing primarily on ileostomy and colostomy complications with the proposed treatment approach.

Even when the stoma is technically adequate, alterations on the corporal image, lifestyle, and sexuality, as well as the need for auto care may occur leading to social and psychological disturbances which difficult the individual social adaptation [1].
