January-March 2018

Clinical Study on Serum Sodium and Potassium Levels In Case Of Ileostomy

M N Khunt1, J P Dave 2, J G Bhatt3, I A Juneja4

1,4Associate Professor,2 Resident Doctor,3 Professor, Dept. Of Gen. Surgery P.D.U. Govt. Medical College, Rajkot


BACKGROUND AND OBJECTIVES: Usually an excess loss of fluid and/ or electrolytes occurs through gastrointestinal tract, respiration, skin, kidney and other abnormal process of elimination like vomiting, fistulas, third space sequestration (where they are not at free equilibrium with rest of the extracellular body fluid) and surgically created ostomies like ileostomy and colostomy. These ostomies effluent is very significant with loop ileostomy with partial resection of ileum, ileostomy and least with colostomy. Our objective is to Study serum sodium and potassium level changes in operated cases of ileostomy. METHODS: This randomized observational prospective cohort study has been carried out in 25 cases of operated cases in which ileostomy done, admitted to department of general surgery in P.D.U Medical College & Hospital , Rajkot from November 2015 to till October 2017. taking proper consent and counseling and evaluated clinically by amount of stoma output, urine output, routine and special investigation (serum electrolytes: sodium, potassium) in Biochemistry department of Rajkot civil hospital by instruments and following measuring techniques- sodium and potassium were measured by ion selective electrode. RESULTS: The study aimed for serum sodium and potassium level changes in operated cases of ileostomy on post-operative day 1st ,3rd,5th . The study shows that:Age of the patient varied from 13 years to 74 years with maximum number of patients seen in the 25-49 years of age group,The most common presentation was abdominal pain (ileal perforation).The value serum sodium ranges 141-130 mmol/l on post-operative day 1, 140-127 mmol/l on post-operative day 3 and 138-123 mmol/l on post-operative day 5,The values of serum potassium ranged from 3.2-4.5mmol/l on postoperative day 1, 4.4-3 mmol/l on postoperative day 3 and 4.3-2.9mmol/l on postoperative day 5. CONCLUSION: Patients, who underwent ileal resection in addition to ileostomy, had a significantly higher stoma output. The patients showed a significant fall in serum electrolyte levels, especially sodium, potassium. Serum sodium value fell below normal range by the 5th post operative day.

Keywords: serum sodium and potassium level,ileostomy

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