[size=20px]A six-month old male child undergoes a diverting colostomy for Hirschprung associated enterocolitis.

 

Which of the following statements about colostomies is true?

 

A colostomies have a prolapse rate of less than five percent

 

B prolapse of the proximal stoma is common in a distal left colostomy

 

C loop colostomies have a higher complication rate

 

D transverse colostomies rarely have prolapse problems

 

E mucus fistulas rarely prolapse[/size]

(Untitled)

 

c

c

correct

 

Colostomies are used often in general pediatric surgery to avoid soilage in difficult rectal surgeries as well as to protect the downstream reconstruction in anorectal malformations.

 

Retrospective patient series of stoma complications suggest that stoma prolapse may occur as often as 20% and is the most common colostomy complication.

 

Prolapse seems to occur in mobile portions of the bowel making loop colostomies, midsigmoid and transverse colostomies more prolapse prone. This has caused some authors to suggest that the ideal colostomy in the left lower quadrant has the left colon still in the retroperitoneum, which will fix this in place, decreasing the incidence of prolapse. Mucus fistulas tend to have a propensity to prolapse. In an attempt to lower the risk of mucus fistula prolapse it is important to keep the ostomy opening as narrow as possible