Surgery>>>>>Colon, Rectum, and Anus
Question 10#

A 76-year-old man undergoes an emergent sigmoidectomy for a perforated colon mass. The surgeon performs a Hartmann procedure and brings up a colostomy. In an emergency setting, where is the most appropriate location to seat a colostomy?

a. Above the beltline, within the rectus abdominus muscle, away from the costal margin
b. Below the beltline, within the rectus abdominus muscle, near the iliac crest
c. Above the beltline, within the rectus abdominus muscle, near the costal margin
d. Below the beltline, within the rectus abdominus muscle, away from the iliac crest

Correct Answer is A

Comment:

In an emergency operation, like this one, where the stoma site has not been marked, an attempt should be made to place a stoma within the rectus muscle and away from both the costal margin and iliac crest. In emergencies, placement high on the abdominal wall is preferred to a low-lying site.