Complications following ilesostomy are not uncommon. Fluid and electrolyte imbalance, skin excoriation and breakdown, stenosis of the stoma and mechanical small bowel obstruction are the usual problems which may occur. Recently, a new complication following total colectomy and ileostomy has been recognized. Uric acid urolithiasis, usually associated with gout, leukemia or polycythemia, has been found in a significant number of patients after total colectomy.1 Prospective studies report this complication in 9% to 13% of all patients with established ileostomies.2,3
Loss of fluid and electrolytes from the gastrointestinal tract may contribute to this unusually high incidence of uric acid lithiasis, but confirming clinical data is lacking. The purpose of this study is to determine alterations in uric acid excretion in patients with established ileostomies and uric acid calculi. Based on these findings, methods of prevention and management of this complication will be discussed.
Patients
Three patients with established ileostomies