Assignment task:
Description of Procedure:
Patient is brought to the operating room and placed in the supine position after adequate induction of general anesthesia. The patient was prepped and draped in a sterile fashion. Midline incision was made halfway between xiphoid and umbilicus. This pubis was carried down through the subcutaneous tissue dividing the midline raphe entering the peritoneal cavity. The omentum and the peritoneum was enlarged with the incision. There was copious amount of purulent turbid drainage which was then suctioned. Aerobic anaerobic cultures were taken. With bookwalter retractors in place, the patient was positioned appropriately and the small bowel was isolated away. The sigmoid and descending colon were visualized and mobilized. The white line of Toldt extending upwards to the splenic flexure was mobilized off Gerota's fascia from a lateral to medial fashion dividing attachments of the Roux the omentum.
With this accomplished, the left ureter was delineated along its entire course and separated from the thickened phlegmon which was encountered at the area of the proximal to mid sigmoid colon extending down through to the proximal rectosigmoid junction. The rectal stalks and peritoneum were opened. The Harmonic scalpel was used to divide the vasculature. The mesenteric fat was cleared around the proximal rectum. A contour stapler was brought in and fired creating an adequate staple line intervening. Mesentery was divided with the Harmonic scalpel. At this point an area of descending colon slightly proximal to the sigmoid descending colon junction was selected and again the staple was fired across liberating the specimen. The abdomen was copious and was irrigated with 6L of saline solution. Two JP drains are brought in through separate stab incision lateral abdominal wall. One was placed in the left paracolic gutter and the other was placed in the cul-de-sac pelvis near the rectal staple line. Retractors were removed and the skin was buttonholed. The ostomy is then brought up to the dilated opening was and was seen to rest with no tension and good vascularity. The abdominal wall was closed using Prolene in a single layer closure. Skin was copious and irrigated together using staples. The drains were sutured to skin using nylon suture. The ostomy was then matured using the electrocautery and then 3-0 interrupted Vicryl. Ostomy appliance was then placed and the patient was returned to recovery in satisfactory condition.
Findings:
Significant intra-abdominal peritonitis with significant exudative purulence. Large organized pelvic abscess with inflamed area of entire sigmoid colon with the area of perforation of the proximal sigmoid.
Post-Op Condition:
Stable
Post-Op Plan:
She will be maintained surgical floor. Broad-spectrum antibiotics will be continued and await return of bowel function. What are the correct ICD 10 codes Please only code diagnosis codes. Need Assignment Help?