Obstructive and secretory complications of diverting ileostomy

doi:10.3748/wjg.v28.i47.6732

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Dec 21, 2022; 28(47): 6732-6742
Published online Dec 21, 2022. doi: 10.3748/wjg.v28.i47.6732

Obstructive and secretory complications of diverting ileostomy

Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata

Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Miyagi, Japan

Author contributions: Tsujinaka S wrote the manuscript; Suzuki H, Miura T and Sato Y reviewed the manuscript and agreed with submission; Shibata C critically reviewed the manuscript and agreed with submission.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Shingo Tsujinaka, MD, Associate Professor, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Miyagi, Japan. tsujinakas@tohoku-mpu.ac.jp

Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: October 21, 2022
Revised: November 4, 2022
Accepted: November 25, 2022
Article in press: November 25, 2022
Published online: December 21, 2022
Processing time: 89 Days and 22 Hours

Core Tip

Core Tip: This review highlights the etiology, diagnosis, treatment, and prevention of obstructive and secretory complications associated with diverting ileostomy (DI). Obstructive complications at the stoma site (stoma outlet obstruction/stoma-related obstruction, SOO/SRO) affect 5.4%-27.3% of patients with DI. Trans-stomal tube decompression is effective in most cases. Surgical refinement is important for reducing SOO/SRO. Secretory complications (high output stoma, HOS) lead to water and sodium depletion and secondary hyperaldosteronism with electrolyte imbalances. The incidence of HOS is 14%-24%, with an output of 1000-2000 mL/d. HOS treatment includes fluid intake restriction, antimotility and antisecretory drug therapies, and magnesium supplementation. Intensive monitoring and surveillance programs may decrease the readmission rates for dehydration.