# Expl Lap, Abdom washout, graham patch repair of duodenal ulcer



## bill2doc (Oct 11, 2012)

Thinking 43840 + 49905 ???  Does anyone agree?  Thank you 

1. Expl Lap
2. Abdominal Washout
3. Graham patch repair of duodenal ulcer

Upper midline incision was mad and carried through subcutaneous tissues. Abdomen entered and noted fluid focused in right upper quad. An NG tube was placed and stomach decompressed. The abdomen was explored. There was a small perforated duodenal ulcer noted at the anterior wall of the duodenum distal to the pylorus. A suture was placed through the ulcer to contain it through exploration. The remainder of the abdomen was examined. Bowel was run from ligament treitz to the ileocecal junction. No evidence of other lesions. Colon examined with no evidence of lesions. Liver and Spleen both appeared intact w/o lesions. Stomach had no other lesions beyond single ulcer. A tongue of omentum was then freed from the remaining omentum and positioned over the ulcer.  Anchored with suture.  Sutures placed on either side of ulcer and tied over omental tongue.  Abdomen irrigated w/ warm sterile saline. Abdomen examined and no evidence of lesions or hemorrhage. Abdomen then closed.......


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## Grintwig (Oct 11, 2012)

Yes I agree those would be correct.


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