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October 1948


Author Affiliations

Fellow of the American College of Surgeons.; From the Department of Surgery, University of Louisville Medical School, Louisville, Ky.

Arch Surg. 1948;57(4):487-496. doi:10.1001/archsurg.1948.01240020494006

THE GREAT value of ileostomy in the surgical attack on such diseases as ulcerative colitis and multiple colonic polyposis is often nullified partly or wholly by the refusal of patients to submit to the procedure or, having submitted, to bear with fortitude the abnormal, unpleasant and often painful existence which follows. The most important disadvantage to the patient with an ileostomy is the painful excoriation produced by the leakage of ileal content onto the surrounding skin. Many patients attempt to reduce the amount of excoriating discharge by extreme limitation of food and fluid intake, which is detrimental to the proper dietary management of such conditions as ulcerative colitis. Pain, induced semistarvation and the general messiness of the required toilet greatly lower morale and cooperation and limit social and economic activity.

Improvements in the technic of making the ileostomy and in the construction of suitable appliances1 have attempted to minimize