Indications for Enteric Stoma Creation in Emergency Laparotomy for Acute Abdomen: Insights from a Retrospective Descriptive Study

Abstract

The rise in stoma creation after emergency laparotomy has surged significantly in recent years, contrasting sharply with earlier practices of resection and anastomosis. Despite advances in management, which were expected to reduce this trend, it has instead escalated, imposing a burden on healthcare costs and impacting the quality of life for stoma patients. This study seeks to examine the factors influencing the necessity for enteric stomas during emergency laparotomies for acute abdominal conditions. This descriptive observational study was conducted in the Department of General Surgery at a Medical College & Hospital, from November 2022 to January 2024, analyzing data from March 2019 to March 2021. It included 70 patients aged 18 to 60 who underwent enteric stoma creation during emergency laparotomy. Data were collected retrospectively from medical records and analyzed using descriptive statistics. The study included 70 patients with an average age of 43.7 ± 14.4 years; 43 males and 27 females. The primary indications for stoma creation were obstructing colonic cancer (38.5%), non-traumatic small bowel perforation (14.2%), and sigmoid volvulus (11.4%). Ileostomies were predominant (58.5%), with double-barrel ileostomy being the most common (31.4%). Short-term complications occurred in 28.5% of patients, with surgical site infections being the most common (55%). The study highlights a paradoxical increase in enteric stoma creation despite advancements in surgical care. The findings underscore the need for further research into the factors influencing the decision to create a stoma, beyond immediate surgical considerations.