Stomal Stenosis/Stricture

Stomal Stenosis/Stricture

Duncan G. Hartley, MD

Table of Contents

Definition
Risk Factors
Complications
Management

See Also:
*See Ostomy

Definition

Stomal Stenosis/Stricture: Narrowing of the Stoma that Impairs Normal Function

Incidence: 2-15%

Can Occur at the Level of the Fascia, Skin, or Intraluminal

Risk Factors

Risk Factors

  • Peristomal Sepsis
  • Stomal Retraction
  • Inadequate Blood Supply and Ischemia
  • Crohn’s Disease
  • Poor-Fitting Appliance System
  • Poor Surgical Technique

Complications

Can Cause Cramping Pain Followed by Explosive Output

Can Cause Obstruction with Abdominal Pain, Distention, Nausea, and Vomiting

Management

Asymptomatic: Dietary Modifications, Laxatives, and Stool Softeners

Symptomatic:

  • Mild Stenosis: Repeated Dilation
    • Surgical Ostomy Revision if Fails
  • Severe Stenosis: Surgical Ostomy Revision
    • Preferred Approach: Local Revision with Skin Excision and Rematuring
    • Consider Reseating at Another Site if Surrounding Skin is Poor or There is a Significant Parastomal Hernia