Dx-Small bowel intussusception with Meckel diverticulum as a lead point
Procedure-Reduction of intussusception, resection of terminal ileum, and primary anastomosis
After general anesthesia, the patient abdomen was prepped and draped in normal fashion. A supraumbilical transverse skin incision was made.The subcutaneous tissues were divided. The fascia was incised
in the midline and the peritoneal cavity was entered. There was a small amount of clear ascites encountered. The fascia was extended the length of the incision. The small bowel was eviscerated. The ligament of Treitx was in normal location. In the terminal ileum, we discovered a small boel intussusception. It was easily reduced exposing an abnormal Meckel diverticulum. In the antimesenteeric portion of the small bowel, there was a small mass with a cystic component that you can see through the bowel wall. The mesentery of the small segment was divided between silk ties and electrocautery.
small bowel was excised with metzenbaum scissors. A primary anastomosis was performed end to end with interrupted sutures. The cecum and appendix were identified. The mesentery of the appendix was taken down and the appendix wasdivided between the hemostat and silk ties and passed off the field . The small bowel was then returned to the abdominal cavity . The posterior and anterior fascia were closed with running suture. The subcutaneous tissues and skin were closed .
maybe 44160 also ?not sure, please any advice is helpful