Ileostomy construction in complex reoperative surgery with associated abdominal wall defects

Patients who have undergone recent abdominal surgery and have generalized obliterative adhesions provide a major management problem if they require urgent ileostomy for sepsis or fistulization, particularly when there is an associated abdominal wall defect. This report describes a technique for creating an ileostomy through the skin and subcutaneous tissue only, medial to the fascial edge. This minimizes the intraoperative difficulties of stoma creation and reduces the dangers associated with mobilizing enough bowel to bring out through the fascia.