Hi All,
Can I get a little help please. Getting 44120 but can I get anything for the hernia ? Thanks so much!
midline incision was then made and carried through the subcutaneous tissue to the fascia. The fascia was incised and the abdomen opened. There was significant adhesive disease to the midline. There was stretching of the fascia with multiple defects concerning for incisional hernia. The adhesions were taken down. The bowel was exposed. The bowel was run from the ligament of trietz towards the ileocecal junction. In the distal small bowel, there was scarring and multiple adhesive bands. One constricted across the lumen and source of obstruction. Band was divided and bowel released. A second stricture was noted. This band was tighter and the underlying bowel seemed ischemic. Once this band was released, the condition did not improve. The remainder of the bowel was run and all of the scarring that was identified, was divided. Repeat eval at stricture was still concerning, Decision was made to resect this short segment, including in it the more proximal bruised segment. The proximal and distal points of transection were identified. The stapled anastomosis was performed. The common channel was closed. The mesentery was divided. The staple lines sutures of 3-0 silk. The mesenteric defect was closed. The abdominal cavity was examined again, no other lesions were identified. The abdomen was irrigated with saline. The edges of the midline incision were examined. The fascia was attenuated, Decision was made to resect the fascia and dissect out hernia sac using electrocautery. The midline incision was then closed. Umbilical stalk was re-attached to the fascia.. The skin was closed/Dressing...
Can I get a little help please. Getting 44120 but can I get anything for the hernia ? Thanks so much!
midline incision was then made and carried through the subcutaneous tissue to the fascia. The fascia was incised and the abdomen opened. There was significant adhesive disease to the midline. There was stretching of the fascia with multiple defects concerning for incisional hernia. The adhesions were taken down. The bowel was exposed. The bowel was run from the ligament of trietz towards the ileocecal junction. In the distal small bowel, there was scarring and multiple adhesive bands. One constricted across the lumen and source of obstruction. Band was divided and bowel released. A second stricture was noted. This band was tighter and the underlying bowel seemed ischemic. Once this band was released, the condition did not improve. The remainder of the bowel was run and all of the scarring that was identified, was divided. Repeat eval at stricture was still concerning, Decision was made to resect this short segment, including in it the more proximal bruised segment. The proximal and distal points of transection were identified. The stapled anastomosis was performed. The common channel was closed. The mesentery was divided. The staple lines sutures of 3-0 silk. The mesenteric defect was closed. The abdominal cavity was examined again, no other lesions were identified. The abdomen was irrigated with saline. The edges of the midline incision were examined. The fascia was attenuated, Decision was made to resect the fascia and dissect out hernia sac using electrocautery. The midline incision was then closed. Umbilical stalk was re-attached to the fascia.. The skin was closed/Dressing...