# gonadal vein ligation



## kitkatcoder (Apr 18, 2011)

gonadal vein that has a hole (tear) off the vein just off the vena cava was ligated.

This is a female not male.  Should I use 37620?

Thanks in advance for your help

A long midline incision was made.  Upon entering the peritoneal cavity, there was no obvious evidence of hemorrhage.  Hemodynamics remained constant during the induction and
initial exploration.  However, upon retraction of the bowel, large retroperitoneal hematoma was identified extending down the right iliac vasculature and up into the porta hepatis.  With a Thompson-Farley retractor placed, the right colon was mobilized medially with a Cattel maneuver.  The gonadal vein was identified and traced back to a hole just off the vena cava, where it was doubly clipped and ligated.  Hematoma was evacuated.  No obvious venous hemorrhage was identified, but the vena cava could be isolated and Vesselooped at that point.

Further dissection mobilized the duodenum off of the vena cava and identified a second or third portion diverticulum which had a perforation and feculent material exuded.  This was collected as possible, irrigation with peroxide performed and then the duodenal diverticulum was resected using 2 separate fires of an Endo-GIA 3.5 stapler.  This was then oversewn as best could be possible with silk sutures.  The wound was again irrigated and the hematoma further dissected along the vena cava up to the retrohepatic and short hepatics.


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