P173 Split stoma is a safe and viable option in emergency laparotomy for abdominal catastrophe and outcomes after emergency laparotomy

Published Date: 01st September 2026

Publication Authors: Kalaiselvan. R

Introduction
Intestinal anastomosis presents significant risks during damage-limiting emergency laparotomy (EL) for severe abdominal emergencies in critically ill patients. While resection with split stoma formation is an option, it is not often considered by many surgeons due to concerns about subsequent Intestinal Failure (IF).

Materials and Purpose
This retrospective study is performed across two busy units in Liverpool, UK. Patients who underwent EL and split stoma formation were included. Outcomes like survival, nutritional autonomy and timing of reversal were assessed using a prospectively maintained database. Emergency cases involving non-split stomas were used for comparison.

Results
56 patients (27 men; median age 71 [range 24–90] years; ASA 3 [1–4]) had EL following either de novo acute intra-abdominal catastrophe (n = 49) or complications after elective surgery (n = 7). The median hospital stay was 67 days. Thirty-day and ninety-day mortality rates were 5.1% and 7.7%, respectively.

Patients with split stoma (SS) had the fastest reversal rate compared to those with diversion stoma (DS) (p = 0.0001). Survival by age was not significantly different (p = 0.7), and mortality was higher in the DS group but not statistically significant (p = 0.38). Of 56 original patients, 50 (89%) underwent stoma reversal at a median of 4.7 months (range 1.6–15.4). Thirty-four patients (60.7%) needed inpatient parenteral nutrition until reversal and soon became nutritionally independent.

Conclusion
Split stomas present an effective option for managing high-risk patients. Positive outcomes in both survival and nutrition are attainable when proximal stomas are expertly handled, and parenteral nutrition (PN) services are appropriately provided for individuals with intestinal failure.

Majeed, T and Kalaiselvan, R. (2026). P173 Split stoma is a safe and viable option in emergency laparotomy for abdominal catastrophe and outcomes after emergency laparotomy. Colorectal Disease. 28(S1), p.e70578. [Online]. Available at: https://dx.doi.org/10.1111/codi.70578 [Accessed 15 October 2026]