When is an end colostomy indicated?

An end colostomy is indicated primarily when an anastomosis between bowel segments is not possible. This situation can arise in various circumstances, such as severe bowel disease, trauma, or when the tissue quality does not support a safe reconnection of the bowel. In these instances, creating a stoma allows for the diversion of fecal material away from the diseased or compromised bowel section, managing the patient's condition while minimizing the risk of complications associated with anastomosis.

In cases such as diverticulitis, inflammatory bowel disease, or bowel obstruction, while surgical intervention may be required, these conditions may not necessarily mandate an end colostomy if other surgical options, including resection with anastomosis, are viable. Thus, the decision to create an end colostomy is closely linked to the ability to safely perform an anastomosis, making the situation in which anastomosis is not feasible the clear indication for an end colostomy.