| Causes and management of a high-output stoma. | |
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MedLine Citation:
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PMID: 19888956 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: Patients with a high-output stoma (HOS) (> 2000 ml/day) suffer from dehydration, hypomagnesaemia and under-nutrition. This study aimed to determine the incidence, aetiology and outcome of HOS. METHOD: The number of stomas fashioned between 2002 and 2006 was determined. An early HOS was defined as occurring in hospital within 3 weeks of stoma formation and a late HOS was defined as occurring after discharge. RESULTS: Six-hundred and eighty seven stomas were fashioned (456 ileostomy/jejunostomy and 231 colostomy). An early HOS occurred in 75 (16%) ileostomies/jejunostomies. Formation of a jejunostomy (defined as having less than 200 cm remaining of proximal small bowel; n = 20) and intra-abdominal sepsis? obstruction (n = 14) were the commonest causes identified for early HOS. It was possible to stop parenteral infusions in 53 (71%) patients treated with oral hypotonic fluid restriction, glucose-saline solution and anti diarrhoeal medication. In 46 (61%) patients, the HOS resolved and no drug treatment was needed, 20 (27%) patients continued treatment, six (8%) of whom went home and continued to receive parenteral or subcutaneous saline, and nine died. Twenty-six patients had late HOS. Eleven were admitted with renal impairment and four had intermittent small-bowel obstruction. Eight patients were given long-term subcutaneous or parenteral saline and two also received parenteral nutrition. All had hypomagnesaemia. Conclusion: Early high output from an ileostomy is common and although 49% resolved spontaneously, 51% needed ongoing medical treatment, usually because of a short small-bowel remnant. |
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Authors:
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M L Baker; R N Williams; J M D Nightingale |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland Volume: 13 ISSN: 1463-1318 ISO Abbreviation: Colorectal Dis Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-24 Completed Date: 2011-05-18 Revised Date: 2011-12-06 |
Medline Journal Info:
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Nlm Unique ID: 100883611 Medline TA: Colorectal Dis Country: England |
Other Details:
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Languages: eng Pagination: 191-7 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland. |
Affiliation:
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Nutrition Support Team, Department of Dietetics, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Colostomy Dehydration / etiology Humans Hypercalciuria* Ileostomy Jejunostomy Magnesium / blood Middle Aged Nephrocalcinosis* Postoperative Complications Renal Tubular Transport, Inborn Errors* Surgical Stomas* |
| Chemical | |
Reg. No./Substance:
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7439-95-4/Magnesium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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