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Case Reports: Reminder of important clinical lesson
Postoperative risks of stoma formation in patients with dementia
  1. Isaac Jarratt Barnham1 and
  2. Niall Kent2,3
  1. 1Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
  2. 2Department of Engineering, University College London, London, UK
  3. 3Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK
  1. Correspondence to Isaac Jarratt Barnham; isaac.jarrattbarnham{at}stcatz.ox.ac.uk

Abstract

Stoma formation for patients with dementia presents an increasing problem in a global ageing population. While potentially lifesaving, stomas impose significant, long-term postoperative burdens on patients, and may particularly challenge those with cognitive impairment.

In this case, a patient was considered for colostomy to manage a colovesical fistula. The patient’s cognitive status significantly influenced clinicians’ beliefs concerning suitability for stoma formation.

The relevance of dementia to stoma formation is underdiscussed within the literature. In this report, we outline the postoperative risks to which those with dementia undergoing stoma formation are particularly vulnerable. These include increased risk of psychological harm, of relocation to a nursing home, and of stoma-related complications.

We hope an increased appreciation of these postoperative challenges will inform decisions concerning suitability for stoma formation in this patient group.

  • Memory disorders (psychiatry)
  • General surgery

https://doi.org/10.1136/bcr-2021-246037

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    Footnotes

    • Twitter @niallkent

    • Contributors IJB wrote the manuscript under the supervision of NK.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.