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Provies the ICD-10-PCS codes 4. Operative Report PREOPERATIV

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Provies the ICD-10-PCS codes 4. Operative Report PREOPERATIVE… Provies the ICD-10-PCS codes4. Operative ReportPREOPERATIVE DIAGNOSIS: Obstruction of the rectum in a patient with known colon cancerPOSTOPERATIVE DIAGNOSIS: Obstruction of the rectum due to compression from tumorOPERATION PERFORMED: Diverting transverse loop colostomyINDICATION FOR PROCEDURE: The patient is a 45-year-old white female who underwent a sigmoid colectomy approximately 18 months ago for colon cancer and then underwent adjuvant therapy. She presents today with crampy abdominal pain and underwent CT of the abdomen which demonstrated peritoneal implants as well as a tumor in her pelvis and large tumor growth near her rectum.PROCEDURE: After informed consent was obtained, the patient was taken to the OR and place in the supine position. After successful induction of general endotracheal anesthesia, the patient’s abdomen was prepped and draped in a sterile fashion. A #10 blade was used to make a small transverse incision overlying a mark in the left upper quadrant which had been marked preoperatively. Dissection was taken down through the subcutaneous tissue to the level of the fascia which was divided sharply in the lateral aspect of the rectus abdominis muscle and also divided with the electrocautery. The peritoneum was entered and extended the length of the incision. The transverse colon was readily identified and this was grasped and mobilized into the wound. The omentum was dissected off of the colon and a mesenteric defect was created and a stomal rod passed underneath the colon, thus supporting the loop up into the wound. The electrocautery was then used to make a transverse opening in the colon and then the ostomy was matured using interrupted 3-0 Vicryl sutures in a standard fashion. A suction was then placed down each limb of the loop colostomy to allow for decompression. A colostomy appliance was then applied. The patient tolerated the procedure well and was awakened and extubated without difficulty. She was taken to the PACU in stable condition.ScienceHealth ScienceMBC 158

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