In the classification of stomas, a loop colostomy differs from an end colostomy primarily in that:

• A Loop colostomy is always placed in the sigmoid colon; end colostomy is always transverse
• B Loop colostomy preserves continuity with both proximal and distal bowel, allowing easier reversal; end colostomy requires laparotomy for reversal (Hartmann reversal) ✓
• C Loop colostomy produces liquid effluent; end colostomy produces formed stool
• D Loop colostomy has a higher parastomal hernia rate than end colostomy

Explanation

The fundamental anatomical distinction is that a loop colostomy brings a loop of bowel to the skin surface with both the proximal (functional/efferent limb) and distal (afferent/defunctioned) openings exteriorized — continuity is maintained and reversal is technically straightforward without laparotomy in most cases. An end colostomy (Hartmann's procedure) divides the bowel with the proximal end exteriorized and the distal end oversewn; reversal (Hartmann reversal) requires formal laparotomy. Loop colostomies are used for decompression and diversion; end colostomies are used when future reversal may not be possible.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.