Gastrointestinal System Disorders Q 283 - Gyan Darpan : Learning Portal
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Monday 11 April 2022

Gastrointestinal System Disorders Q 283



Sitty, a 66 y.o. patient underwent a colostomy for a ruptured diverticulum. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor?
  
    A. Blanched stoma
    B. Edematous stoma
    C. Reddish-pink stoma
    D. Brownish-black stoma
    
    

Correct Answer: D. Brownish-black stoma

A brownish-black color indicates lack of blood flow, and maybe necrosis. Necrosis occurs if the blood supply to the stoma is restricted. Initially, the stoma will become a darker red/purple and may even turn black, which is an indication that the blood supply is impaired. It may also feel cold and hard to touch. It is vital that you seek urgent medical attention.

Option A: A blanched or pale stoma indicates possible decreased blood flow and should be assessed regularly. 2 days postoperatively, the stoma should be edematous and reddish-pink.
Option B: It is normal for the stoma to be edematous postoperatively. Stoma edema begins immediately postoperatively. The stoma looks swollen within 4 to 6 hours, swelling progresses for the first 2 days, and by the fifth day subsides markedly.
Option C: A healthy stoma is pinkish-red and moist. The stoma should stick out slightly from the skin. It is normal to see a little mucus. Spots of blood or a small amount of bleeding from the stoma is normal.

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