# EGD / Pyloric Dilation / Kenalog Injection



## plynn (Jul 11, 2013)

This is a first for me, I need all the help I can get 

*Report:*
the tubular esophagus appeared to be normal. thee was evidence of previous surgery in the stomach. the stomach had a very small pouch. the anastomotic stricture was at about 50 cm from the incisors. the Z-line was about 42 cm from the incisors. the scope was passed into the small bowel without any problem. there were a few erosions noted in the stomach. this appeared to be NSAID-induced erosions. the anastomotic stricture was dilated with a TTS pyloric balloon at 12-15 mmHg. first the balloon was inflated to 13.4 mmHg and held for a minute. it was deflated completely and then reinflated to 15 mmHg and held for another minute. there was minimal amount of bleeding at the dilation site. after this, Kenalog 40mg/mL was injected at the anastomotic stricture site. this was done at 2.5-ML aliquots at 4 different places. the patient tolerated the procedure well. there were no complications. 

My thought for EGD with gastric outlet dilation was 43245, however unsure about Kenalog injection (?)

Can someone please let me know if I am even in the ball field
I appreciate your help
plynn


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## Kisalyn (Jul 26, 2013)

Multiple endoscopic techniques were performed at the stricture.

43236 is bundled into 43245. I would report the 43245 as this is the comprehensive procedure.

Anyone else?


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