Current indications for blow-hole colostomy: Ileostomy procedure. A single center experience

Feza H. Remzi*, Mustafa Oncel, Tracy L. Hull, Scott A. Strong, Ian C. Lavery, Victor W. Fazio

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background and aims: Because of improved medical care and surgical techniques blow-hole colostomy with loop ileostomy is now rarely performed to reduce operative risks in patients with toxic megacolon related to inflammatory bowel disease (IBD). We reviewed patient charts to identify continuing indications for this procedure. Patients and methods: Seventeen patients underwent blow-hole colostomy procedure with (n=15) or without (n=2) ileostomy (8 men, 9 women; median age 51 years, range 21-79) during the past 18 years (1983-2001). Results: The indications for the procedure were: toxic megacolon related to IBD (n=6), toxic megacolon related to IBD and associated with pregnancy (n=2), Clostridium difficile colitis (n=3), adult Hirschsprung's disease (n=1), pancreatitis with obstructing pseudocyst (n=1), and palliation for malignant bowel obstruction with metastases (n=4). Patients were discharged home after a median stay of 10 days (range 4-32 days). The 4 patients who underwent a palliative blow-hole procedure had died secondary to their underlying disease by the time of follow-up. Of the remaining 13 patients 12 had their alimentary tract reconstituted, and one still awaits a definitive procedure. Conclusion: The blow-hole colostomy-ileostomy procedure is still indicated for select patients with toxic megacolon and large-bowel obstruction. The procedure acts as a bridge to definitive operation for toxic patients with benign disease and palliates those with malignant obstructions and metastasis.

Original languageEnglish (US)
Pages (from-to)361-364
Number of pages4
JournalInternational Journal of Colorectal Disease
Issue number4
StatePublished - Jul 2003


  • Clostridium difficile colitis
  • Large bowel obstruction
  • Toxic colitis
  • Turnbull blow-hole colostomy

ASJC Scopus subject areas

  • Gastroenterology


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