DOCSLIB.ORG

Unusual Case-Small Bowel Hemangioma Diagnosed With

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Unusual Case-Small Bowel Hemangioma Diagnosed With Unusual Case Small bowel hemangioma diagnosed with laparoscopy: Report of two pediatric cases A E Jones, B H Ainsworth, A Desai, T T Tsang Department of Paediatric Surgery, Norfolk and Norwich University Hospital NHS Trust, Colney Lane, Norwich, NR4 7UY, UK Address for correspondence: A. E. Jones, 59 Wernddu Road, Ammanford, Dyfed, UK. E-mail: [email protected] Abstract Hemangiomas of the small bowel usually present with intestinal bleeding. This may be acute with massive Hemangiomas of the small bowel are rare tumors blood loss which can be life threatening or chronic that often present with gastrointestinal bleeding. Diagnosis can be difficult and exploratory with anemia as in our two cases. Other forms of laparotomy has often proved to be the only method presentation include intussusception,[2] small bowel with which to determine the presence and location obstruction and perforation.[1,3] Diagnosis of small of these tumors.We report two cases of small bowel bowel hemangiomas can be difficult and exploratory hemangioma in children aged 10 and 7 years, in laparotomy has often proved to be the only method which the diagnosis was made by laparoscopy. Laparoscopy identifies the affected segment of with which to determine the presence and location bowel and allows delivery to a minimally extended these tumors.[1,3] We report two cases of small bowel umbilical port site. The avoidance of an open hemangioma in children aged 10 and 7 years in which laparotomy helps to reduce post-operative analgesic the diagnosis was made by laparoscopy. requirement and achieves an early return of bowel function. .com). CASE REPORT Key words: Hemangioma, laparoscopy, pediatric, small bowel The first patient was a 10-year-old girl who was under investigation for recurrent abdominal pain and iron .medknowdeficiency anemia requiring blood transfusions. INTRODUCTION Physical examination was unremarkable. Blood count revealed hemoglobin of 6.8 g/dL, mean cell volume Hemangiomas of the gastrointestinal tract(www are rare (MCV) of 72. Double contrast barium follows through and account for only 0.05% of all intestinal and Technetium 99 meter pertechnetate (Meckel’s) neoplasms.[1] They are commonly found within the scan were normal. In addition, anti-endomysial and small bowel andThis comprise PDFa site 7-10%is hostedavailable of all benignby forMedknow freeautoimmune download Publications antibody from screens were normal. tumors.[1] The commonest location within the small However, fecal occult blood tests were positive on a bowel is the mid-jejunum.[1] They have a tendency number of occasions. Upper and lower toward multiplicity with solitary tumors being gastrointestinal endoscopies were arranged, however, extremely rare.[1,2] Hemangiomas have an association before these investigations could be performed, the with systemic angiomatoses such as blue rubber bleb patient presented acutely with collapse and melaena. naevus syndrome, Maffucci’s syndrome, and Klippel- Following fluid resuscitation, she underwent urgent Trenaunay-Weber syndrome. Grossly, an intestinal oesophago-gastro-duodenoscopy (OGD) and colon­ hemangioma is usually soft and polypoid; it is red, oscopy, both of which revealed no abnormality. Lapar­ blue or wine-colored, and varies in size from a few oscopy was undertaken at the same time and revealed millimeters to a large polypoid mass projecting into a 2 cm vascular malformation of the jejunum [Fig­ the lumen or infiltrating the bowel wall.[1] ures 1 and 2], which was resected with primary jeje- 29 Journal of Minimal Access Surgery | January-March 2007 | Volume 3 | Issue 1 CMYK29 Jones, et al.: Small bowel hemangioma diagnosed with laparoscopy to allow resection of the affected bowel segment and primary end-to-end anastomosis. She made an une­ ventful recovery and was found to have normal he­ moglobin and hematinics at follow up. Histology confirmed a cavernous hemangioma extending through the full thickness of the bowel wall. DISCUSSION Hemangiomas of the small bowel are rare tumors that often present with gastrointestinal bleeding. They are commonly found in the small bowel and hence often make diagnosis difficult. Initial Figure 1: Laparoscopic view of the jejunal hemangioma investigations in the patient with gastrointestinal bleeding often include upper and lower gastrointestinal endoscopy, barium contrast study, and a Meckel’s scan. These investigations are often normal and while useful in excluding other diagnoses, do not provide clear indication of a hemangioma. Other investigations such as red blood cell scan and angiography have a rather low yield when the vascular malformation is not actively bleeding and one may have to resort to exploratory laparotomy to determine the presence and location [1,3] these tumors..com). Laparoscopy as employed in our two cases allows a diagnosis to be made without performing a Figure 2: Opened specimen showing ulcerated haemangioma on the laparotomy. The laparoscopy identifies the affected mucosal side of the jejunum segment of bowel and if open excision is subsequently nal end-to-end anastomosis via mini laparotomy .medknowper- required, allows delivery to a minimally extended formed by extending the umbilical trocar incision. umbilical port site. Resection and anastomosis is then She made an uneventful recovery and follow up at 6 performed in the usual manner. A port site is months revealed a normal blood count (wwwand hematin- positioned at the umbilicus for the laparoscope, with ics. Histology of the resected bowel confirmed a je- two lower abdominal ports for instruments. The small junal vascularThis malformation. PDFa site is hostedavailable by forMedknow freebowel download Publicationsis examined from from the ileocecal junction prox­ imally. Laparoscopy can be performed in conjunction The second patient was a 7-year-old girl who initially with upper and lower gastrointestinal endoscopy presented with a three weeks history of lethargy, under the same anesthetic, as in our first case. Prior anorexia, and abdominal pain. Physical examination insufflation of the gastrointestinal tract during en­ was normal. On admission, her hemoglobin was 4 g/ doscopy did not create any difficulties for the lapar­ dL with an MCV of 62 and required blood transfusion. oscopy or identification of the pathology in this case. Fecal occult blood tests were negative. A Meckel’s The avoidance of an open laparotomy helps to re­ scan, abdominal ultrasound scan, OGD and colonos­ duce post-operative analgesic requirement and copy were normal. She underwent laparoscopy, which achieves an early return of bowel function. revealed a 2 cm hemangioma in the distal jejunum. Furthermore, there is the added cosmetic benefit of A mini laparotomy was performed via the umbilicus the small umbilical scar in girls. Journal of Minimal Access Surgery | January-March 2007 | Volume 3 | Issue 1 30 30 CMYK Jones, et al.: Small bowel hemangioma diagnosed with laparoscopy Laparoscopy in these two cases also allowed a thor­ REFERENCES ough examination of the whole length of small bow­ el using the ‘walking’ maneuver. The good light 1. Boyle L, Lack EE. Solitary cavernous hemangioma of small intestine. Case report and literature review. Arch Pathol Med Lab source and magnification enabled easy viewing of 1993;117:939-41. any mesenteric or seromuscular abnormalities. We 2. Morgan DR, Mylankal K, el Barghouti N, Dixon MF. Small bowel did not proceed to intra-operative small bowel hemangioma with local lymph node involvement presenting as intussusception. J Clin Pathol 2000;53:552-3. endoscopy as we felt that additional large hemangi­ 3. Ramanujam PS, Venkatesh KS, Bettinger L, Hayashi JT, Rothman omas were unlikely. We were also confident that the MC, Fietz MJ. Hemangioma of the small intestine: Case report resected specimen had had a recent bleed because of and literature review. Am J Gastroenterol 1995;90:2063-4. the eroded appearance of the mucosal surface of the hemangioma when examined intra-operatively. We Cite this article as: Jones AE, Ainsworth BH, Desai A, Tsang TT. Small believe laparoscopy compliments other modalities in bowel hemangioma diagnosed with laparoscopy: Report of two pediatric the management of occult gastrointestinal bleeding cases. J Min Access Surg 2007;3:29-31. and the use of various modalities or in combination Date of submission: 17/08/06, Date of acceptance: 06/11/06 can be considered depending on the circumstances. Source of Support: Nil, Conflict of Interest: None declared. .com). .medknow Author Help: Reference checking facility (www The manuscript system (www.journalonweb.com) allows the authors to check and verify the accuracy and style of references. The tool checks the references with PubMed as per a predefined style. Authors are encouraged to use this facility before submitting articles to the journal. This PDFa site is hostedavailable by forMedknow free download Publications from • The style as well as bibliographic elements should be 100% accurate to get the references verified from the system. A single spelling error or addition of issue number / month of publication will lead to error to verifying the reference. • Example of a correct style Sheahan P, O’leary G, Lee G, Fitzgibbon J. Cystic cervical metastases: Incidence and diagnosis using fine needle aspiration biopsy. Otolaryngol Head Neck Surg 2002;127:294-8. • Only the references from journals indexed in PubMed would be checked. • Enter each reference in new line, without a serial number. • Add up to a maximum 15 reference at time. • If the reference is correct for its bibliographic elements and punctuations, it will be shown as CORRECT and a link to the correct article in PubMed will be given. • If any of the bibliographic elements are missing, incorrect or extra (such as issue number), it will be shown as INCORRECT and link to possible articles in PubMed will be given. 31 Journal of Minimal Access Surgery | January-March 2007 | Volume 3 | Issue 1 CMYK31.
Load more

Recommended publications
  • Evidence Vs Experience in the Surgical Management of Necrotizing Enterocolitis and Focal Intestinal Perforation
    Journal of Perinatology (2008) 28, S14–S17 r 2008 Nature Publishing Group All rights reserved. 0743-8346/08 $30 www.nature.com/jp ORIGINAL ARTICLE Evidence vs experience in the surgical management of necrotizing enterocolitis and focal intestinal perforation CJ Hunter1,2, N Chokshi1,2 and HR Ford1,2 1Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA and 2Department of Surgery, Childrens Hospital Los Angeles, Los Angeles, CA, USA bacterial colonization and prematurity.4 There is a subset of low Introduction: Necrotizing enterocolitis (NEC) and focal intestinal birth weight infants, however, that sustain focal intestinal perforation (FIP) are neonatal intestinal emergencies that affect premature perforation (FIP) without classic clinical, radiographic, or infants. Although most cases of early NEC can be successfully managed with histological evidence of NEC.5 FIP appears to be a distinct clinical medical therapy, prompt surgical intervention is often required for advanced entity that occurs in 3% of very low birth weight (VLBW) infants or perforated NEC and FIP. and accounts for 44% of gastrointestinal perforations in this 6 Method: The surgical management and treatment of FIP and NEC are population. Optimal surgical management of severe NEC and discussed on the basis of literature review and our personal experience. FIP has been the subject of ongoing controversy for many years. Result: Surgical options are diverse, and include peritoneal drainage, laparotomy with diverting ostomy alone, laparotomy with intestinal Presentation of NEC and FIP resection and primary anastomosis or stoma creation, with or without Infants with NEC typically present with feeding intolerance and second-look procedures.
    [Show full text]
  • Exploratory Laparotomy.Docx
    EXPLORATORY LAPAROTOMY CONSENT FORM Your physician has determined that you may have a disease or abnormality inside your abdomen which may be life threatening, preventing pregnancy or causing medical problems if not treated. An exploratory laparotomy is an operation in which the doctor makes a surgical “cut” in the belly. Sometimes this operation is done to make sure that no disease or abnormality exists. If the physician finds that a disease is found or if the physician doesn’t feel that corrective surgery should be done immediately, then he will close up the surgical cut. If major corrective surgery is done the risk will be greater than if no corrective surgery is done. It is possible that you will be worse after the operation. Your physician can make no guarantee as to the result that might be obtained from this operation. Complications from exploratory surgery of the abdomen without any corrective surgery are infrequent, but they do occur. As with any surgical procedure, complications from bleeding and infection can occur. These complications can result in prolonged illness, the need for blood transfusions, poor healing wounds, scarring and the need for further operations. Other uncommon complications of this operation include: Damage to the intestines, blocked bowels, hernia or “rupture” developing at the site of the surgical cut, heart attacks or stroke, blood clots in the lungs and pneumonia. Some complications of exploratory surgery of the abdomen may require further surgery, some can cause permanent deformity and rarely, some can even be fatal. Furthermore, there may be alternative therapeutic or diagnostic methods available to you in addition to exploratory surgery.
    [Show full text]
  • Laparoscopy and Possible Laparotomy
    Saint Mary’s Hospital Major Laparoscopy (and possible Laparotomy) Information For Patients Contents What is a Laparoscopy? 3 What is it used for? 4 Proceeding to a Laparotomy 5 Will I have pain following my operation? 5 Vaginal bleeding 6 When can I have sex again? 6 Will my periods be affected? 6 When can I return to normal activities? 6 Constipation following a Laparotomy 7 How will my wound be closed? 7 How should I care for my wound? 8 Will I have a scar? 8 Safety 8 Contact numbers 9 Other useful numbers 9 2 What is Laparoscopy? A laparoscopy is a surgical procedure that allows the surgeon to access the inside of the abdomen and the pelvis. He does this using a laparoscope, which is a small flexible tube that contains a light source and a camera. The camera relays images of the inside of the abdomen or pelvis to a television monitor. Laparoscopy is a minimally invasive procedure and is performed as keyhole, surgery, so the surgeon does not have to make large incisions (cuts) in the skin. A small incision is made in the skin, and the laparoscope is passed through the incision allowing the surgeon to study the organs and tissues inside the abdomen or pelvis. The advantages of this technique over traditional open surgery are that people who have a laparoscopy have: • A faster recovery time, • Less pain after the operation, • Minimal scarring. 3 What is it used for? • Diagnostic uses Sometimes scans and other tests can help us with diagnosing problems. However, sometimes the only way to confirm a diagnosis is to directly study the affected part of the body using a laparoscope.
    [Show full text]
  • Are the Best Times Coming?
    Liu et al. World Journal of Surgical Oncology (2019) 17:81 https://doi.org/10.1186/s12957-019-1624-6 REVIEW Open Access Laparoscopic pancreaticoduodenectomy: are the best times coming? Mengqi Liu1,2,3, Shunrong Ji1,2,3, Wenyan Xu1,2,3, Wensheng Liu1,2,3, Yi Qin1,2,3, Qiangsheng Hu1,2,3, Qiqing Sun1,2,3, Zheng Zhang1,2,3, Xianjun Yu1,2,3* and Xiaowu Xu1,2,3* Abstract Background: The introduction of laparoscopic technology has greatly promoted the development of surgery, and the trend of minimally invasive surgery is becoming more and more obvious. However, there is no consensus as to whether laparoscopic pancreaticoduodenectomy (LPD) should be performed routinely. Main body: We summarized the development of laparoscopic pancreaticoduodenectomy (LPD) in recent years by comparing with open pancreaticoduodenectomy (OPD) and robotic pancreaticoduodenectomy (RPD) and evaluated its feasibility, perioperative, and long-term outcomes including operation time, length of hospital stay, estimated blood loss, and overall survival. Then, several relevant issues and challenges were discussed in depth. Conclusion: The perioperative and long-term outcomes of LPD are no worse and even better in length of hospital stay and estimated blood loss than OPD and RPD except for a few reports. Though with strict control of indications, standardized training, and learning, ensuring safety and reducing cost are still and will always the keys to the healthy development of LPD; the best times for it are coming. Keywords: Laparoscopic, Pancreaticoduodenectomy, Open surgery, Robotic, Overall survival Background pancreatic surgeries were performed in large, tertiary The introduction of laparoscopic techniques in the care centers.
    [Show full text]
  • Pancreaticoduodenectomy for the Management of Pancreatic Or Duodenal Metastases from Primary Sarcoma JEREMY R
    ANTICANCER RESEARCH 38 : 4041-4046 (2018) doi:10.21873/anticanres.12693 Pancreaticoduodenectomy for the Management of Pancreatic or Duodenal Metastases from Primary Sarcoma JEREMY R. HUDDY 1, MIKAEL H. SODERGREN 1, JEAN DEGUARA 1, KHIN THWAY 2, ROBIN L. JONES 2 and SATVINDER S. MUDAN 1,2 1Department of Academic Surgery, and 2Sarcoma Unit, The Royal Marsden Hospital, London, U.K. Abstract. Background/Aim: Sarcomas are rare and disease is complete surgical excision with or without heterogeneous solid tumours of mesenchymal origin and radiation. The prognosis for patients with retroperitoneal frequently have an aggressive course. The mainstay of sarcoma is poor, with 5-year survival of between 12% and management for localized disease is surgical excision. 70% (2), and the main cause of disease-related mortality Following excision there is approximately 30-50% risk of following surgery is local recurrence (3). However, there is developing distant metastases. The role of pancreatic a risk of up to 30% of developing distant metastases (4), and resection for metastatic sarcoma is unclear. Therefore, the in these patients, it is the site of metastatic recurrence rather aim of this study was to asses the outcome of patients with than of the primary sarcoma that determines survival (5). pancreatic metastases of sarcoma treated with surgical The commonest site for metastases of sarcoma are the lungs. resection. Patients and Methods: A retrospective analysis of Metastatic tumours arising in the pancreas are rare, a prospectively maintained single-surgeon, single-centre accounting for approximately 2% of all pancreatic cancer (6, database was undertaken. Seven patients were identified who 7).
    [Show full text]
  • Disposable Free Three Port Laparoscopic Appendectomy – Low Cost Alternative for Emergency
    Gastroenterology & Hepatology: Open Access Research Artilce Open Access Disposable free three port laparoscopic appendectomy – low cost alternative for emergency Abstract Volume 11 Issue 2 - 2020 Rationale: Video laparoscopic appendectomy does not have a single protocol on technical systematization, access routes, energy use, and staplers. The cost of disposable materials Carlos Eduardo Domene, Paula Volpe, may prevent its widespread use. Alternatives to lower the cost can help disseminate Frederico Almeida Heitor, André Valente laparoscopic access in appendectomy. Santana Integrated Center for Advanced Medicine and Unified Objective: This study aimed to introduce a method in performing video laparoscopic Treatment Center for the Obese, Brazil appendectomy at low cost and aiming at a good aesthetic result through the location of its incisions and show its viability through its application in 1552 cases of video laparoscopic Correspondence: Carlos Eduardo Domene, A study appendectomy performed between 2000 and 2019 with three portals, with extremely low conducted at the Integrated Center for Advanced Medicine and cost in inputs used. Unified Treatment Center for the Obese, São Paulo, Brazil, Email Methods: Three punctures were performed – one umbilical puncture to introduce the camera (5 or 10mm in diameter), one 10mm puncture in the right iliac fossa, and one Received: March 08, 2020 | Published: April 28, 2020 5-mm puncture in the left iliac fossa. The last two punctures were performed medially to the epigastric vessels, which can be visualized with the aid of the laparoscopic camera externally, by transparency, or internally, under direct vision. The materials– trocars, grasping forceps, hooks, scissors, and needle holders, are of permanent use, without the need for any disposable material.
    [Show full text]
  • Duodenal Perforation Caused by Eyeglass Temples: a Case Report
    Case Report Annals of Clinical Case Reports Published: 27 Jan, 2020 Duodenal Perforation Caused by Eyeglass Temples: A Case Report Zhiyong Dong1#, Wenhui Chen1#, Jin Gong1, Juncan Zhang1, Hina Mohsin2 and Cunchuan Wang1* 1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, China 2Department of Neurology, California University of Science and Medicine, USA #These authors contributed equally to this work Abstract Background: While some foreign bodies in the digestive system can be egested spontaneously or after ingesting lubricants, generally long, large, sharp, irregularly shaped, hardened and/or toxic foreign bodies frequently remain in the digestive system. These foreign bodies may cause obstruction or damage the gastrointestinal mucosa leading to bleeding, perforation, and/or acute peritonitis, and may even cause local abscess, fistula formation, or organ damage. Case Report: A 30-year-old Chinese man was presented with acute abdominal pain while intoxicated with alcohol and swallowed two eyeglass temples. Conservative measures including ingesting lubricants to egest the foreign bodies failed. He underwent two exploratory laparotomy that showed a duodenal perforation and eventually the two eyeglass temples retrieved. Conclusion: This is the first report describing a patient who had swallowed eyeglass temples. Patients who swallow such objects must be promptly examined and diagnosed by ultrasound, X-ray, and/or CT, and foreign bodies removed by laparoscopy or laparotomy. Keywords: Duodenal perforation; Foreign body; Exploratory laparotomy OPEN ACCESS Introduction *Correspondence: Cunchuan Wang, Department of The effects of foreign bodies in the digestive system depend on their texture, shape, size, toxicity, Gastrointestinal Surgery, The First retention site, and duration [1]. Report of foreign bodies includes dentures, glass beads, coins, pens, Affiliated Hospital of Jinan University, fish bones [2].
    [Show full text]
  • Approaches to Abdominal Colorectal Surgery
    To make an appointment or ask a question, continued from other side call the Division of Colon and Rectal Surgery and occasionally a laparoscopic procedure must be at 617-636-6190. Approaches converted to an open laparotomy by making a longer incision. This might be necessary if there is bleed- For urgent problems, call the Tufts Medical Center to Abdominal ing, the small bowel cannot be kept out of the way, operator at 617-636-5000 and ask for the there are extensive adhesions or scar tissue, or the on-call physician for Colon and Rectal Surgery. problem cannot be clearly seen or managed. Above Colorectal Surgery all, the surgeon must feel that the operation is going well and is as safe as possible. to robotic surgery including a better view than with a laparoscope. The robotic videoscope is binocular – it uses The operation is performed through several 1 inch two cameras, one for each eye, which gives the surgeon incisions. Metal or plastic tubes (ports) with a seal- Surgical Options a three-dimensional view and better depth perception. ing cap are placed through these incisions, and the The robotic instruments have a “wrist” which bends in abdomen is distended with carbon dioxide gas like 6 directions. This mimics the natural movement of the a tent or dome. A laparoscope attached to a camera surgeon’s wrist and is more flexible than laparoscopic is placed through one of the ports and connected to instruments, allowing the surgeon to get around corners, a video monitor to allow the surgeon and assistants to sew and to retract much better than possible with to see inside the abdomen.
    [Show full text]
  • Colonoscopy-Assisted Colostomy--An Mternative to Laparotomy Report of Two Cases
    Colonoscopy-Assisted Colostomy--An Mternative to Laparotomy Report of Two Cases Asish Mukherjee, M.D., Virendra A. Parikh, M.D., Pedro S. Aguilar, M.D. From the Division of Colon and Rectal Surgery, Grant Medical Center, Columbus, Ohio PURPOSE: The objective of this study was to evaluate the drainage from multiple sites in the perineum and feasibility of performing fecal diversion with the help of a scrotum. Antibiotics were effective initially but failed colonoscope without a concomitant laparotomy. METH- ODS: Colostomies were performed on two patients who to control subsequent flareups. Examination revealed needed fecal diversion and who would benefit from avoid- extensive induration, with multiple sites of purulent ing the morbidity of laparotomy. A colonoscope was used in discharge. The entire skin of the buttocks and part of each case to guide the surgeon in selecting the appropriate the scrotum were involved. The anoderm was spared, bowel segment. RESULTS: No complications related to the colostomy were noted in either patient. CONCLUSIONS: and no lesions or internal fistulous openings were The technique of colonoscopy-assisted colostomy that we noted at anoscopy and rigid sigmoidoscopy. Wide have described offers an acceptable method of creating excision and skin grafting were recommended. There a stoma without the need for laparotomy. [Key words: Colonoscopy; Colostomy; Fecal diversion] was an obvious need for fecal diversion without any Mukherjee A, Parikh VA, Aguilar PS. Colonoscopy-assisted specific need to perform a laparotomy. Colostomy colostomy--an alternative to laparotomy: report of two was performed without a laparotomy by use of the cases. Dis Colon Rectum 1998;41:1458-1460.
    [Show full text]
  • What Is an Emergency Laparotomy? Foundation Trust Review Date: June 2018 Author: Dr Caroline Busby, Mr V Chitre NU 62 Version 1
    © June 2015 James Paget University Hospitals NHS What is an Emergency Laparotomy? Foundation Trust Review Date: June 2018 Author: Dr Caroline Busby, Mr V Chitre NU 62 version 1 Aim of information An emergency laparotomy is a major operation that involves opening the abdomen (tummy). This allows the surgeon to view the organs inside and repair any emergency problems that have occurred. It is called “emergency” because it must be done very soon or even immediately and cannot wait until a later date. Why is the operation necessary? An emergency laparotomy is commonly performed for infections due to perforated or inflamed bowel, a blockage to the bowel or internal bleeding. There are several other conditions that can also require emergency laparotomy, such as perforations or infections in the gall bladder or appendix, and abdominal injuries due to trauma. In most of these cases, there is no effective alternative to an emergency laparotomy. When there are alternatives, your surgeon will discuss these with you when seeking your consent for the operation. Your anaesthetist will discuss the implications of having a general anaesthetic and, if there are any alternatives, in your case. What will happen during the operation? After the anaesthetist puts you to sleep and ensures that you will not feel pain, the surgeon makes a large cut in the front of your tummy, to open the abdomen. It is sometimes necessary to remove a length of bowel. The cut ends of the remaining bowel can often be joined up at the same time; the join is called an anastomosis. However, sometimes it is unsafe to join the two ends of bowel immediately; the risk of leakage is increased if there is a lot of pus or infection.
    [Show full text]
  • Icd-9-Cm (2010)
    ICD-9-CM (2010) PROCEDURE CODE LONG DESCRIPTION SHORT DESCRIPTION 0001 Therapeutic ultrasound of vessels of head and neck Ther ult head & neck ves 0002 Therapeutic ultrasound of heart Ther ultrasound of heart 0003 Therapeutic ultrasound of peripheral vascular vessels Ther ult peripheral ves 0009 Other therapeutic ultrasound Other therapeutic ultsnd 0010 Implantation of chemotherapeutic agent Implant chemothera agent 0011 Infusion of drotrecogin alfa (activated) Infus drotrecogin alfa 0012 Administration of inhaled nitric oxide Adm inhal nitric oxide 0013 Injection or infusion of nesiritide Inject/infus nesiritide 0014 Injection or infusion of oxazolidinone class of antibiotics Injection oxazolidinone 0015 High-dose infusion interleukin-2 [IL-2] High-dose infusion IL-2 0016 Pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance Pressurized treat graft 0017 Infusion of vasopressor agent Infusion of vasopressor 0018 Infusion of immunosuppressive antibody therapy Infus immunosup antibody 0019 Disruption of blood brain barrier via infusion [BBBD] BBBD via infusion 0021 Intravascular imaging of extracranial cerebral vessels IVUS extracran cereb ves 0022 Intravascular imaging of intrathoracic vessels IVUS intrathoracic ves 0023 Intravascular imaging of peripheral vessels IVUS peripheral vessels 0024 Intravascular imaging of coronary vessels IVUS coronary vessels 0025 Intravascular imaging of renal vessels IVUS renal vessels 0028 Intravascular imaging, other specified vessel(s) Intravascul imaging NEC 0029 Intravascular
    [Show full text]
  • Exploratory Laparotomy Post-Surgery Information
    Exploratory laparotomy post-surgery information An exploratory laparotomy procedure involves a midline incision in the abdomen and a visual assessment of all abdominal organs. During this time, foreign bodies may be removed from the intestines or stomach, stones removed from the bladder and with your consent, small biopsies of organs may have been obtained for testing. Just as with human abdominal surgery, this is considered a major procedure and it is very important to follow post-surgery instructions to allow your pet to heal well. Tonight When you pick up your pet today you may notice the following: - Your pet may be more drowsy than normal due to the anaesthesia and pain relief medication administered. - It is important that they be kept indoors tonight in a warm, quiet place where they can be monitored and allowed to rest. - Please only offer your pet water tonight. Do not give them any food tonight. - Your pet may have a small cotton band-aid on one of their fore (or occasionally hind) legs where access to the vein was obtained. Please remove this after 2 hours of picking them up from the clinic. - The wound, which is on the underside of the tummy, may appear mildly bruised or there may be slight bleeding from the wound. It is not normal however for the wound to continuously drip blood or for there to be bleeding or bruising developing elsewhere on the body. These findings could indicate a clotting/bleeding disorder. If this is noted please contact the clinic immediately. Day 1 - Please start the medication/s as directed on the label/s.
    [Show full text]