First application of Ultrasound to examine bowel movement in stoma patients by Nurse Consultant

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Authors (including presenting author) :
Ho CW(1), Ada Chan WY(1), Kara Lau KY(1), Lau CW(1), Tang CN(1)
Affiliation :
(1) Pamela Youde Nethersole Eastern Hospital
Introduction :
Life adaptation, peristomal and parastomal skin are common major concerns in every stoma patient. Instead, their bowel movements are rarely reported. Sometimes they may experience abdominal bloating when constipation. Despite the bowel can be grossly investigated by X-ray imaging, it often delays. Auscultation of bowel sound can be conveniently assessed by stethoscope, but it may be influenced by environment and highly subjective. The aim of this study is to introduce the ultrasound technology to examine the bowel function in stoma patients.
Objectives :
To explore an advanced scientific diagnostic tools to assess the bowel functions to stoma patients after the colorectal surgery
Methodology :
During the ultrasound examination on parastomal spaces, using the linear probe and the frequency was calibrated down to 4.2Mhz. Probe fanning and rotation were the key orientation to visualize the bowel loop under the abdominal wall. The bowel movement could be clearly noted just down below the rectus abdominis muscle. Presence of fecal impaction could be further examined distal down to the colostomy. Using the Pulse Doppler, the bowel sound, waveform and scale could be characterized.
Result & Outcome :
During May to December 2018, 40 patients with ended sigmoid colostomy after the colorectal surgery recruited. 28 patients reported normal bowel sound and waveform; 10 patients experienced halted bowel movement for postoperatively intestinal ileus. 2 stenosis stoma patients reported significantly low in bowel movement and fecal impaction, and the Power Doppler showed weak waveforms. The study identified particular concerns related to bowel examination on stoma patients. By the ultrasound technology, the bowel movement, bowel sound, waveform and fecal impaction could be easily characterized. A limitation of our study is the small samples and local segment of bowel loop in parastomal spaces examined in patient group. The follow-up correlation study on bowel functions using the ultrasound will be studied in near future. However, the pioneer application of ultrasound in stoma care nursing which is the milestone to develop advanced nursing practice in stoma care.
Nurse Consultant

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