Deuterostomy

Deuterostomy is a surgical term referring to the creation of an artificial opening (a stoma) between the lumen of the gastrointestinal tract and the external abdominal wall. The use of the term is limited and not widely standardized in modern practice. In many contemporary texts, deuterostomy is described as synonymous with duodenostomy (opening into the duodenum) or, less commonly, with jejunostomy (opening into the proximal small intestine). Practically, the intended segment and purpose determine the exact terminology; many surgeons prefer the more specific terms for the organ involved (duodenostomy, jejunostomy, ileostomy, etc.). Deuterostomy is generally considered a form of enterostomy used to divert intestinal contents, drain secretions, or provide access for feeding or decompression when the distal GI tract cannot be used.

Indications include obstruction, leakage from a distal anastomosis or fistula, preparation for palliative care, or temporary diversion during healing after trauma or surgery. The procedure involves creating a tract through the abdominal wall into the chosen intestinal segment, bringing a portion of the lumen to the skin, and securing it to prevent leakage. Stoma care and nutritional support are important components of management.

Potential complications include stoma stenosis or retraction, skin irritation, infection, peristomal hernia, leakage, electrolyte imbalance, and, rarely, intra-abdominal infection or fistula formation. Given its limited use, deuterostomy is typically considered only when other, more standard procedures are unsuitable. It should not be confused with embryological deuterostome development.