Which factor is a listed contributing factor to stoma necrosis?

• A. Hypotension/hypovolemia
• B. Hyperthyroidism
• C. Staphylococcal infection
• D. Diabetes mellitus

Answer: (A)

Stoma necrosis happens when the blood supply to the created stoma is compromised, leading to tissue ischemia. The factor most directly linked to this is systemic low blood pressure or reduced circulating volume, because when perfusion falls, the mesenteric and stomal tissues don’t receive enough oxygen and nutrients to stay viable. This is why hypotension/hypovolemia is the listed contributing factor: it directly impairs blood flow to the stoma, increasing the risk of necrosis in the early postoperative period.

Other options don’t directly cause ischemic necrosis of the stoma. Hyperthyroidism isn’t typically associated with reduced stomal perfusion. A staphylococcal infection can damage surrounding skin but doesn’t by itself cause necrosis of the stoma tissue. Diabetes can impair healing and increase infection risk, but the primary mechanism for necrosis remains inadequate perfusion rather than these conditions alone.

Clinically, healthy stomal tissue appears pink to red and moist; dusky, pale, or black discoloration suggests ischemia. If ischemia or necrosis is suspected, address hemodynamics promptly and consult the surgical team.