Indications and outcome of reoperation for ileostomy complications in inflammatory bowel disease.

Indications for ileostomy revision in 49 patients with inflammatory bowel disease operated upon between January 1975 and December 1984 were obstruction (15), retraction (10), parastomal hernia (9), prolapse (8), and fistula (4). Recurrent Crohn's disease was an important factor in the pathogenesis of ileostomy complications particularly obstruction, retraction and fistula. Local revision without laparotomy was successful in seven of eight patients with an ileostomy prolapse, but in only four of eight patients with a retracted stoma. Results of local repair without laparotomy and resiting were successful in five of six patients with a parastomal hernia. Laparotomy was usually necessary in patients with obstruction especially if there was underlying Crohn's disease and in patients with peristomal fistula. Resiting of the stoma after laparotomy was used only if the stoma site was outside the rectus muscle or if the original stoma site was infected.