# Abdominal Wall Hematoma



## GSCoder07 (Oct 17, 2013)

I need some assistance on this one. The physician told me the area he debrided was 30 cm x 20 cm. I was thinking 11042 & 11045 x 29? I don't know if I'm way off base on this. 
Thank you so much in advance for your help! 

Operative note:
PREOPERATIVE DIAGNOSES:  Right lower quadrant anterior abdominal wall hematoma,
large.
POSTOPERATIVE DIAGNOSES:  Right lower quadrant anterior abdominal wall hematoma,
large.
OPERATION:  Evacuation right lower quadrant anterior abdominal wall hematoma.

OPERATIVE NOTE:  The patient was brought to the operating room, entered under general
anesthesia.  She was prepped and draped in the usual fashion over the right lower
quadrant of her anterior abdominal wall.  A transverse incision was made over this
large tense mass that was fluctuant in the right lower quadrant.   A transverse
incision was made and carried down through the skin and subcutaneous tissues with
electrocautery.  There was a huge underlying hematoma of the anterior abdominal wall
with many different little fingers extending up and down.  There was some devitalized
tissue in this area, which we debrided.   The hematoma pockets were irrigated
copiously with saline, and we evacuated all of the palpable blood clot that we could
find.  This was really a massive amount of blood.   The tissues appeared to be a lot
of it torn up; and, again, we debrided the devitalized tissue.  There was really no
active bleeding.
I placed a round 19-French Jackson-Pratt drain through the hematoma pocket and then
closed the skin with staples.   I brought the drain out superiorly on the right flank
and secured it with a 3-0 nylon suture.   The patient tolerated this procedure well.


----------

