Wiki Colorectal Head-Spinner

rlohearn

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St Peters, MO
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Any help would be appreciated with this complex case. It's essentially 44155, but can't be coded as such because it was performed in pieces over three op sessions. It's a bit of a stumper for me; any colorectal experts out there up to a challenge?!?! Here's a summary (the op notes are rather extensive):

Op 1: Resected terminal ileum and all but the sigmoid colon. No anastomosis; pt left in discontinuity intentionally (massive distention, fecal contamination, etc.) with intent to revisit later. Abdomen left open, wound VAC applied.

Op 2 (three days later): Resected sigmoid colon, took core biopsies of rectum.

Op 3 (next day): Resected rectum and did ileostomy (and took out the gallbladder, for good measure!).

Thanks in advance for any and all suggestions!
 
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