Complications of colostomy and colostomy closure in Ibadan, Nigeria

• Published in: International Journal of Medicine and Health Development Vol. 6; no. 1; pp. 13 - 16
• Main Authors: Emmanuel R Ezeome, Ezekiel O Alawale, Clement A Adebamowo, Opeoluwa O Adekunle
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 01.01.2001
• Subjects: colostomy; colostomy closure; complications; ibadan; nigeria
• ISSN: 2635-3695

Objective: To define the incidence of, and factors contributing to the complications of colostomy and colostomy closure at the University College Hospital, Ibadan, Nigeria. Patients and Method: Retrospective review of hospital records of all the patients that had colostomy/colostomy closure in the hospital from 1985 to 1994 was conducted. Two hundred and sixty nine colostomies were performed, 154 of which were fully evaluated. Loop colostomies on the sigmoid (35.7%) and transverse colon (27.3%) were most commonly performed. Indications for colostomy in adults were rectal carcinoma, acquired fistulae, colorectal injury and colonic obstruction. Anorectal anomalies and Hirschsprung's disease were the indications in children. Complications and deaths related to colostomy and colostomy closures were noted. Results: Death rate was 17.6% mostly from sepsis. Mortalities were higher (p<0.05) in neonates, emergencies, anorectal anomalies, colonic obstruction, rectal prolapse and cases done by resident doctors. Overall, morbidity rate was 60.5%. The most common complication was colostomy prolapse, which occurred most frequently in loop colostomies. Significantly higher morbidity (p<0.05) was recorded in children, loop colostomies and cases done by resident doctors. Fifty-three of 117 temporary colostomies were closed without mortality. Complication rate was 54.7%, mostly from wound infection (45.3%). Faecal fistula was the most difficult complication of colostomy closure. Conclusions: Morbidity and mortality of colostomy is high in Nigeria. More consultants' inputs are needed in colostomy creation especially in neonates, emergencies, obstructed cases and patients with rectal prolapse. Primary closure of colostomy wounds should be avoided.