Overview

 

Ileostomy, colostomy, and
urostomy diversions are
commonly used in the
management of congenital
and acquired diseases in
neonates, infants, and
older children.

The primary goal in gastrointestinal surgery is the preservation of all possible bowels. When the urinary tract is affected, the primary goal is preservation of renal function and decompression of the upper tracts with future reconstructive efforts directed toward the establishment of continence. Fortunately, many of these stomas are temporarily placed to allow the affected area to heal and/or grow, with few patients requiring a stoma for a lifetime.


WHAT IS A STOMA?

The terms ostomy and stoma are descriptive terms that are often used interchangeably. An ostomy is a surgically created opening between the gastrointestinal (GI) or genitourinary (GU) tract and the skin. A stoma is the actual portion of the urinary tract or small or large intestine that is brought through an incision in the abdominal wall and can be seen protruding through the skin. The surgically created stoma is usually named for the structures involved in the diversion.


The digestive system is known by a variety of names, including the gastrointestinal (GI) tract, the "gut," and the alimentary canal. They all refer to the long muscular tube in which the food we eat is broken down chemically into molecules usable by the body's cells, and finally is either absorbed into the bloodstream or eliminated from the body. The process of digestion, which is what is happening to food in the alimentary canal, involves a complex series of events. The digestive tract spans the mouth, esophagus, stomach, the small and large intestines, and accessory organs such as the liver, gallbladder, and pancreas.

The-gastrointestinal-system_NEW

The GI tract is responsible for the ingestion, digestion, and absorption of nutrients, as well as the storage and elimination of faecal waste.

The genitourinary (GU) tract is made up of the kidneys, ureters, bladder, and urethra. Clinicians often divide the urinary tract into the upper and lower tracts. The upper urinary tract comprises the kidneys and ureters, which are primarily responsible for the removal of waste substances from the blood and fluid and electrolyte regulation. The lower urinary tract, bladder, and urethra are responsible for urine evacuation from the body.

Genitourinary-tract_NEW

In children there are a variety of anatomic anomalies, pathologic processes, or traumatic injuries that may necessitate the creation of a diversion at any level
of the urinary tract, either temporarily or permanently.

Urinary diversions have been associated with complications such as urinary
tract infections, stone formation, obstructions, renal deterioration, and
electrolyte disturbances. For this reason, when it is anticipated that a
permanent urinary diversion is indicated, the trend is to create a continent urinary diversion such as a catheterisable reservoir.


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