Stoma case sharing

Portal hypertension is associated with the development of varices in various sites, most commonly the esophagus and stomach. However, varices can also occur further down the gastrointestinal tract, including the small bowel, colon, and rectum, and in association with enterostomies; these are called ectopic varices, and these stomas generally bleed. Next, please follow me to see the case of stoma varicose veins.

Diagnose based on:

It can be seen that the skin around the stoma is purple and the surrounding skin is thinning; the dilated and flexed blood vessels extend radially around the stoma; the mucous membrane around the stoma may be accompanied by hyperemia and redness

What is the reason for this?

1. Most cases of ileostomy varices are patients undergoing colectomy for ulcerative colitis, and their portal hypertension is mainly secondary to primary sclerosing cholangitis and liver cirrhosis.

2. Colostomy and ileal urethrostomy varicose veins generally occur in patients with bowel or urinary tract diversion due to rectal cancer and bladder cancer. The most common causes of portal hypertension are tumor liver metastasis and alcoholic cirrhosis of the liver.

3. The oppression and wear of the hard bottom plate of the stoma bag or the leakage and corrosion of excrement at the stoma are the causes of bleeding from varices of the stoma.

How to prevent complications:

Avoid pressure, collision, trauma, and friction on the stoma and its surrounding skin; clean and replace the stoma bag gently; unnecessary sticky products should be avoided, because removing these products will increase trauma and bleeding. It is recommended to use a soft chassis. The hard chassis and belt should not be too oppressive when used. The opening size of the cut stoma chassis should be suitable for protecting the stoma and the stoma from injury. Reduce the number of times to replace the chassis, and the chassis should be replaced gently

Care of bleeding complications:

If the skin around the stoma is bleeding, the pouch should be torn off immediately to evaluate the bleeding site. Bleeding is usually in the form of jets, and compression should be used immediately to stop the bleeding and press the bleeding site. If necessary, Alginate Dressing can be used, and then Elastic Bandage Self-Adhesive can be used to stop bleeding. If treatment is ineffective, please contact your physician.

Here are some common causes of peristomal skin lesions:

Leakage: Healthy skin exposed to feces or urine under a skin barrier can deteriorate rapidly.

Pressure: Belts and some clothing can put pressure on the stoma area.

Stoma size: Make sure the stoma tray is cut to size. It should always fit snugly over the stoma (1-2mm long) to prevent leakage.

Wrinkles or skin folds: Choose different shapes of stoma tray products so that the stoma tray fits perfectly on the skin to prevent leakage.

Skin peeling or rubbing: Do not remove the skin barrier too quickly as this can damage the surface of the skin. The more often this happens, the more likely the skin will become irritated.

For more information on Innomed® skin barrier, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

At Longterm Medical, we transform this data by innovating and developing products that make life easier for those who need loving care.

Reference: " Guiding Opinions on Nursing of Enterostomy in China 2013 "

Editor: kiki Jia

Date: December 16, 2022