International Surgery Journal | March 2021 | Vol 8 | Issue 3 Page 930
International Surgery Journal
Chejara R et al. Int Surg J. 2021 Mar;8(3):930-934
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
Evaluating outcomes in patients of jejunal stoma
Rajkumar Chejara, Rohit Chaudhary*, Ashok Sharma, Dheer Singh Kalwaniya,
Ankur Garg, Monish Raj M., Vignesh M.
INTRODUCTION
A stoma is an opening, either naturally or surgically
created which connects a portion of the body cavity to the
outside environment. Stomas formed from the bowel are
named in relation to their location within the
gastrointestinal tract. A stoma from proximal small bowel
(less than 200 cm remaining of small bowel is referred as
jejunostomy, one formed from the distal small bowel an
ileostomy.
1
Ileostomy is usually preferred because it is
well tolerated as it results in minimal or negligible
nutritional and metabolic disturbances. However in
managing patients with intra-abdominal emergency such
as perforation of bowel due to trauma, intestinal
tuberculosis or in patients with mechanical obstruction
with strangulation, we are sometimes left with no other
option but to construct a jejunostomy as the patients
general condition is very critical or there is intra-
abdominal sepsis with high chances of anastomotic leak
and eventual mortality. Jejunostomy carries a high
morbidity and mortality as the stoma output is very high
because jejunal mucosa is highly permeable resulting in
ABSTRACT
Background: In managing patients with intraabdominal emergency such as perforation of bowel due to trauma,
intestinal tuberculosis or in patients with mechanical obstruction with strangulation, we are sometimes left with no
other option but to constitute a jejunostomy as the patients general condition is very critical or there is intra-
abdominal sepsis with high chances of anastomotic leak and eventual mortality. In this article we have evaluated
outcomes of jejunal stoma in terms of morbidity and mortality.
Methods: Study conducted in the Department of Surgery, VMMC and Safdarjung Hospital, New Delhi. 25 patients
were evaluated in study for a period of 18 months between October 2018 and April 2020. Patient demographics,
preoperative diagnosis, treatment strategies, surgical procedures, and the post-operative course were evaluated.
Results: It was observed that the most common pathologies for formation of jejunostomy were trauma and
tuberculosis. patients were readmitted, most commonly due to cause being dehydration and dyselectrolytaemia.80%
patient had clavien dindo grade 1 pre-operative complications. Mean time for stoma closure was 5.4 weeks. Most
common complication after closure of stoma was Surgical site infection i.e.,9 patients (36%). Overall mortality was 2
(8%).
Conclusions: It is concluded from our study that if jejunostomy has to be made due to unavoidable circumstances
then the patient requires regular clinical assessment of nutritional parameters and aggressive corrections of any
abnormalities and an early closure of stoma. This shows that knowledge of clinical course of patient with jejunostomy
can help us to better manage these patients.
Keywords: Complications, Jejunal stoma, Outcomes
Department of General Surgery, Safdarjung Hospital, New Delhi, India
Received: 25 December 2020
Revised: 07 February 2021
Accepted: 09 February 2021
*Correspondence:
Dr. Rohit Chaudhary,
E-mail: chaudharyrohit467@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20210929