Loop ileostomy versus loop colostomy for fecal diversion

Abstract

Loop ostomies, fashioned either from the terminal ileum, transverse colon, or sigmoid colon are well-established methods for diverting the fecal stream. Important anatomic considerations, such as patency of the left colic artery and marginal artery and competency of the ileocecal valve, must be considered when creating diverting loop ostomies. Diverting loop ileostomies are associated with higher rates of dehydration and renal insufficiency due to higher stoma output, but have lower rates of prolapse than loop colostomies. Closure of loop ileostomies is associated with lower rates of wound infection but higher rates of post-closure obstruction versus loop colostomies. In emergent cases with a distended remaining colon, diverting loop transverse colostomies may be indicated due to the presence of a competent ileocecal valve.