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31 Cards in this Set
- Front
- Back
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Name a common type of a conventional ostomy
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ileostomy
colostomy urostomy |
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Name a common type of alternate ostomy procedure
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continent ileostomy
Pelvic pouch (IPAA) Continent urostomy orthotopic urinary diversion |
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Describe a conventional ileostomy
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temporary or permanent
effluent is liquid to slightly pasty Most common location is the RLQ |
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Describe a pelvic pouch (IPAA/ileal pouch anal anastomosis)
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Internal ileal reservoir created from distal small bowel.
Continence is achieved by sphincter and pelvic floor muscles. Goal is to avoid the need for a pouch. |
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Who are candidates for a pelvic pouch?
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Patient with mucosal ulcerative colities (MUC) and FAP (Familial adenomatous polyposis)
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Describe a continent ileostomy
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Internal intestinal reservoir created from distal small bowel.
CANDIDATES are pts with mucosal ulcerative colitis; failed pelvic pouch or inadaquate shincters for pelvic pouch. Continence is achieved by nipple valve created by intusseption and/or plication of the terminal ileum. |
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What is the main indication for a colostomy?
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Cancer
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Describe what to expect with a cecostomy
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Output- semi liquid to pasty
May be projectile effluent (due to proximity to ileocecal valve) Watch for electrolye imbalance Located in RLQ Function begins around 3rd post op day |
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Describe what to expect with an ascending colostomy.
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semi liquid to pasty effluent
Watch for fluid and electrolyte imbalance RLQ Function 3rd day post op |
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What can you expect with a transverse colostomy
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Output is pasty to semi solid
Frequently located in mid abdomen Functions around 4th day post op |
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Describe descending/sigmoid colostomy
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Most common.
Output is semi-solid to formed Absorption/manufacture of Vit K & folic acid is not affected LLQ Functions around 7th day post op. May be irrigated. |
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What is the #1 cause of bladder CA?
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Smoking
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Name the types of urostomies.
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Vesicostomy
Ureterostomy Nephrostomy Conduits: ileal, sigmoid, jejunal Continent urinary diversion Orthotopic urinary diversions |
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Describe a vesicostomy
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Bladder wall is everted and sutured to the skin.
Located: suprapubic region |
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Describe a ureterostomy
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Ureter is exteriorized to the anterior or posterior (flank) abdomen
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Describe the condition of Biliary Atresia
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Pathologic obliteration of the extra hepatic bile ducts.
Kasai procedure is the surgery commonly performed. |
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Exstrophy of the Cloaca
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Failure of the abdominal wall to close exposing intestinal and urinary organs.
Surgery: Colostomy or ileostomy |
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Familial Adenomatoeus Polyposis Coli (FAP)
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Autosomal dominant inherited condition characterized by intestinal, especially colon, dysplasia. Adenoma is cell most affected.
Surgery: Pelvic pouch or ileal rectal anastomosis. |
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Hirshprungs Disease
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Intestinal defect characterized by the absense of ganglion cells resulting in a non-relaxation phase of peristalsis.
Surgery: swenson pull-through |
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Imperforate Anus
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Abnormal patency and/or ectopic location of the anus
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Inflammatory Bowel Disease
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Strikes most often between 15 and 35 years of age. Has been diagnosed in children as young as 2 years.
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Mucosal Ulcerative Colitis
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Inflammation of mucosal layer of colon.
Characterized by bloody diarrhea and failure to thrive. Surgery: Pelvic Pouch or subtotal colectomy and end ileostomy |
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Crohn's Disease
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Transmural inflammation that can affect entire GI tract.
Characterized by diarrhea, abdominal pain and failure to thrive. |
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Meconium Ileus
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Intestinal obstruction due to abnormal, putty like meconium.
Seen in 10-15% of neonates with cystic fibrosis Surgery: Temporary ileostomy and flushing of colon |
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Necrotizing Enterocolitis
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Segment of gangrenous bowel.
Occurs in 3-8% of premature infants weighing less than 2000 grams |
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Omphalocele
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Herniation of abdominal contents through the umbilical base with the amniotic membrane covering the contents.
Surgery: Possible temporary ileostomy with abdominal closure. |
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Volvulus
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Torsion of a loop of intestine.
Surgery: Possible temporary ileostomy with bowel resection. |
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Extrophy of the bladder
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Failure of anterior abdominal wall to fuse, resulting in exposure of everted bladder epithelium
Surgery: Bladder reconstruction or urinary diversion. |
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Posterior Urethral Valves
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Results in bladder outlet obstruction or impediment to flow of urine.
Surgery: Primary fulguration of the valves. Possible urinary diversion. |
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Prune-belly Syndrome
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AKA: Eagle Barrett Syndrome
Absence of abdominal musculature resulting in varying degrees of distortion of the urinary system. In males, undescended testes. Hydroureter Surgery: Abdominalplasty. Usually temporary ureterostomies. |
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Spina Bifida (Myelomeningocele)
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Defect in the fusin of the bony spine with associatied spinal cord involvement.
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