Стома кишечника фото, "Стома дала мне свободу". Как жить, если удален кишечник
При этом обязательно соблюдение диеты, чтобы каловые массы были пасто- или кашеобразными, либо водянистыми. With such stomas, one trunk is active, through which the bowel is emptied. Это место свободно от крупных рубцов, шрамов; должно быть достаточным и удобным для крепления калоприемника.
The stoma can be permanent or temporary. Permanent stoma can not be eliminated in the course of further treatment of the patient, because there is no or irreversible damage to the intestinal locking apparatus, or there is no way to quickly restore the continuity of the intestinal course. Stomas can be single-barrelled that is, through an opening on the anterior abdominal wall, one intestinal trunk is removed and double-barrelled.
Moreover, the latter are divided into loop that is, two trunks are in close proximity to each other and are withdrawn into one hole and separate double-barrel stomas, when there are two holes on the anterior abdominal wall at some distance from each other.
In this case, when using stoma care products, the colostomy bags should not overlap each other even if the distance between the stomas is very small.
With such stomas, one trunk is active, through which the bowel is emptied. A colostomy bag is glued to the active trunk.
Another trunk may be needed for mucus removal or medical procedures. It can be covered with a mini-cap closed bag of minimal capacity or a gauze napkin. Depending on the part of the intestine that is removed to the anterior abdominal wall, the following types of intestinal stomas are distinguished: colostomy when removing the large intestine and ileostomy when removing the small intestine.
Colostomy Several types of colostomy can be distinguished by the place of superposition: cecostoma, ascendostoma, transversostoma, descendostoma, sigmostoma. With colostomy, bowel emptying usually occurs times a day, the stool is formed with sigmostoma or semi-formed with other types of stomas.
Ileostoma With ileostomy, bowel emptying occurs very often, almost constantly, the stool is liquid and acrid. A common problem with ileostomy is diarrhea, which can lead to dehydration and loss of electrolytes, minerals and vitamins. Therefore, it is very important to consume a lot of liquid.
Urostoma Urostoma is formed when the bladder needs to be removed. Urine is diverted through a dedicated section of the intestine, to the upper end of which the ureters are sewn, and the lower end is removed to the anterior abdominal wall. Urinary excretion is constant and uncontrolled.
With urostoma, there is a constant outflow of urine through the stoma. How the stoma changes The size and shape of the stoma may vary. After surgery, the stoma is usually swollen, bleeds a little and has a bright red color.
Over time, the postoperative wound heals, the swelling subsides, the size of the stoma decreases, and its color becomes red-pink. After weeks, the stoma will fully form. Do not be alarmed if you notice that the stoma is slightly increased, then decreased. This occurs as a result of the contraction or expansion of the wall of the removed intestine. However, you should regularly monitor the size of the stoma.
During the first weeks after surgery, the size of the stoma should be determined weekly, and then monthly for the first year. In the future, it is recommended to determine the size of the stoma every six months. Stoma complications and their prevention Sometimes stoma patients have to deal with various types of complications associated with the presence and functioning of an intestinal or ureteral stoma on the abdominal wall. These complications become a cause of serious concern for patients, so we will focus on them in more detail.
Irritation of the skin in the area of the superimposition of the stoma parotid dermatitis Dermatitis is observed quite often, it is the result of mechanical irritation frequent change of colostomy bags, careless skin treatment , or chemical exposure to intestinal discharge or urine leakage under the plate, poorly selected, leaky colostomy bag.
Its manifestations: redness, blisters, cracks, wet, oozing sores on the skin near the stoma. Skin irritation causes itching, burning, and sometimes severe pain. Possible allergic reaction of the skin to devices and products for the care of the stoma, if it is very pronounced, you should for some time abandon the use of glued bags. In such cases, the question of choosing the type of colostomy bag should be decided by the doctor. Often, the cause of skin complications is simply insufficient skin care in the area of the superimposition of the stoma.
In case of irritation of the skin around the stoma, you need to consult a proctologist, stomatotherapist and dermatologist.
Bleeding from the stoma In most cases, it is caused by damage to the intestinal mucosa due to careless care of the stoma or the use of coarse materials. The edge of a tight hole in the plate, the rigid flange of the colostomy bag can also injure the intestine and cause bleeding. Bleeding usually stops spontaneously. But if it is prolonged and plentiful, you should consult a doctor.
Narrowing stenosis The stoma should be passable, freely pass the index finger. Narrowing is usually caused by inflammation in the area of the stoma in the early postoperative period. If the narrowing reaches a degree that interferes with the emptying of the intestine, it is necessary to perform an operation to expand the opening. If the stoma is narrowed, do not take laxatives without consulting a surgeon! Retraction of the stoma retraction This is a retraction of the intestinal wall below the level of the skin, circular or partial.
The presence of a funnel-shaped depression significantly complicates the care of the stoma and requires the use of special two-component colostomy bags with a convex concave plate and additional care products special pastes for leveling the skin surface and protecting it. In case of ineffectiveness of these measures, surgical treatment is undertaken.
Complete loss of all layers of the intestinal wall disrupts the function of emptying, makes it difficult to care for the stoma, and can lead to intestinal obstruction.
The loss increases in the standing position, when coughing, during physical exertion. Одноствольные стомы представляют собой один конец кишки, который выведен на поверхность брюшной стенки.
Из этой кишки поступает каловое содержимое.
Иногда формируют две одноствольные стомы, но в этом случае вторая стома — это отводящий конец кишки, и, разумеется, калового содержимого там не должно быть. Двуствольная стома образована двумя концами выведенной кишки — приводящим и отводящим.
По приводящему концу поступает каловое содержимое, а второй конец - это начало отводящей кишки, которую «выключают» из пассажа кишечного содержимого. В зависимости от своей формы стомы бывают плоские и сформированные столбиком. В первом случае стома находится на одном уровне с кожей. Таким образом, обычно накладывают стомы толстой кишки.
Стомы, которые сформированы столбиком, на см возвышаются над кожей. Таким способом накладывают тонкокишечные стомы. Консистенция отделяемого стомы будет зависеть от отдела кишечника, где эта стома сформирована.
