J.Jpn. Surg. Soc.. 85(10): 1344-1348, 1984

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Original article

PATHOPHYSIOLOGICAL ASSESSMENT FOR CONTINENT ILEOSTOMY IN PATIENTS WITH ULCERATIVE COLITIS
ーWITH SPECIAL REFERENCE TO INTERNAL PRESSURE AND CAPACITY OF ILEOSTOMYー

Eight patients subjected to surgery for ulcerative colitis were followed up for 1－27 years. Of eight, 3 patients received Kock's continent ileostomy and 5 patients end ileostomy. The survey was performed mainly in terms of emptying frequency, the internal pressure and the capacity of the ileostomy. The patients with continent ileostomy empty their reservoirs one to four times a day, while the patients with end ileostomy change the ileostomy bags four to ten times a day. In patients with Kock's ileostomy, high pressure zone was observed at 3 to 6cm proximal to the stoma conesponding to the sito of the nipple valve. The pressure of the nipple valve showed higher than the internal pressure of the reservoir. When the internal pressure at the site of 10cm proximal to the stoma was measured after end ileostomy, it increased proportionally to the amount of infused saline. Infusion of 50ml of saline induced its evacration from the stoma without causing any sensation of fullness to the patients. The patients with Kock's ileostomy announced sensation of fullness when 80% of the maximal capacity of the reservoir was filled with saline. This sensation of fullness made it easy for the patients to control emptying the reservoir. Therefore, we conclude that Kock's procedure should be more widely performed to ulcerative colitis when ileostomy is required.

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