After how many hours after an ileostomy creation with no output should the surgeon/provider be notified?

• A. 48 hours
• B. 60 hours
• C. 72 hours
• D. >72 hours

Answer: (D)

When a new ileostomy is formed, small-bowel function and stoma patency are being watched through the stoma’s output. Some delay in initial output can occur, but if there is zero output for more than about 72 hours, the surgeon or provider should be notified. That threshold is used because a prolonged absence of output raises concern for a mechanical issue such as obstruction, a kink or twist at the stoma, a mucus plug, or a problem with the anastomosis or proximal bowel. Prompt evaluation allows timely imaging or intervention to prevent complications. If the stoma looks nonviable (color changes or dusky appearance) or the patient shows symptoms like dehydration or abdominal pain, contact urgently regardless of the time frame.