There are a number of instances when a colostomy may be necessary. In many circumstances it is performed to protect the distal large bowel after surgery. A further indication would include large bowel obstruction with imminent perforation wherein a colostomy allows decompression of the bowel and its contents. This is a safe and temporizing procedure performed when the patient is too unwell for extensive bowel surgery. It is relatively straightforward and carries reduced risk, preventing significant morbidity and mortality.