Management of patient with prolapsed stoma

Management of patient with prolapsed stoma

 Clinical problems

Stomal prolase occurs more commonly in loop stoma and it can also occur when distal loop. It can often be managed conservatively.

 Description of Past Management

Once stomal prolapse is developed, lay the patient in supine position and pouch with hole of base plate enlarged. If the patient has bowel edema, put sugar on the ostomy and wait for edema to disappear. Manual reduction is needed when spontaneous reduction is not achieved. When it develops into necrosis, emergency op should be done.

 Current Clinical Approach

Once stomal prolapse is developed, when doing manual reduction, pulling with No. 11-12 nelaton catheter was used.

Distal loop was fixed by Convex wafer ring and applied convex base plate with pouch.

 Patient Outcomes

For five transient end loop stoma prolapse patients, prolased distal loop was fixed by using Convex wafer ring. Then, convex plate was applied and after pouching, the whole loop was fixed firmly by stoma belt. As a result, pouching system remained well for 2-3 days without prolapse, until take down of the stoma.

 Conclusions

Appliance of convex wafer ring and convex pouching system for prolapse patient with transient end loop stoma is considered helpful for temporary stoma patient’s well-being and reliance of anxiety.