Peristomal fistulas are most commonly associated with which ostomy type?

• A. Urostomies.
• B. Ileostomies.
• C. Jejunostomies.
• D. Colostomies.

Answer: (B)

Peristomal fistula is a tract that forms from the bowel lumen to the skin around the stoma, typically after ongoing irritation, skin breakdown, or inflammation at the stoma site. The type of effluent coming from the stoma influences how likely this is to occur. An ileostomy produces a highly liquid, enzyme-rich stool that constantly bathes the peristomal skin. This strong irritant environment promotes skin breakdown and tissue injury, increasing the chance that a fistulous tract will form. Colostomy effluent is thicker and less irritant, so fistulas around the stoma are less common there. Jejunostomies can have high output as well, but the condition is most classically associated with ileostomies due to the combination of liquid stool and peristomal skin exposure. Urostomies involve urine rather than stool, making peristomal fistulas in that setting less typical.