Mohammad Nadeem Aslam, Syed Asghar Naqi, Sidra Shoaib.
Management of high output stomas in our setup.
Pak J Med Health Sci Jan ;4(4):526-9.

Objective: To assess efficacy of our regimen (Consisting of reducing hypotonic solutions, antisecretory or antimotility drugs and replacement of lost nutritional elements like magnesium and vitamin D along with high isomolar diet rich in fat and salt) in reducing stoma output in high output fistulas Study design: Descriptive study Patients and methods: Study was conducted in the Department of Surgery, Mayo Hospital Lahore, from Jan 2008 to Jun 2010. All patients with high output stomas (> 1 lit/day), within 3 weeks of surgery were included in the study. Result: 31 patients were found to have output stomas. 9 had jejunostomies and 22 had Ileostomies. Age range was between 20 yrs to 55 years, 17 were males and 19 females. The most common cause for stoma formation was perforation due to tuberculosis, typhoid, iatrogenic gut perforation, covering ileostomy for rectal cancers, following resection anastomosis, blunt abdominal trauma, and anastomotic leaks were other indications. Tuberculosis was the commonest cause for ileal perforation which was seen in 11 (35.48%) patients, followed by typhoid which was present in 7 (22.5%) patients. With our treatment regimen 29 patients were able to stop parenteral infusions, and 2 needed early surgical reversal. Conclusion: This regimen is effective in decreasing output from high output fistulas

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