45915 Removal of fecal impaction or foreign body (separate procedure) under anesthesia

Removal of Fecal Impaction or Foreign Body (Separate Procedure) Under Anesthesia

Name of the Procedure:

• Common Name: Removal of Fecal Impaction
• Technical Terms: Fecal Disimpaction, Foreign Body Removal

Summary

The removal of fecal impaction or foreign bodies is a medical procedure where impacted stool or foreign objects are removed from the rectum and lower colon. This is done under anesthesia to ensure the patient's comfort and minimize pain.

Purpose

• Medical Condition: This procedure addresses severe constipation resulting in fecal impaction or the presence of foreign objects in the rectum or colon that cannot pass naturally.
• Goals: The objective is to relieve obstruction, prevent further complications like bowel perforation or infection, and restore normal bowel function.

Indications

• Severe discomfort or pain due to fecal impaction.
• Chronic constipation unresponsive to other treatments.
• Presence of a foreign body in the rectum or lower colon.
• Abdominal bloating, nausea, or vomiting due to impaction.
• Complications such as infections, bleeding, or tears in the intestines caused by the impaction or foreign body.

Preparation

• Fasting: Patients may be required to fast for 6-8 hours before the procedure.
• Medications: Adjustments or temporary discontinuation of certain medications as directed by the physician.
• Diagnostic Tests: Possible imaging studies like an X-ray or CT scan to locate the impaction or foreign body.

Procedure Description

• Step 1: The patient is brought to the procedure room and positioned appropriately.
• Step 2: Anesthesia is administered, usually general anesthesia or deep sedation.
• Step 3: A lubricated gloved finger or special instruments are used to gently break up and remove the impaction or retrieve the foreign body.
• Step 4: The rectum is inspected for any signs of damage or complication.
• Tools/Technology: Gloves, lubricants, anoscope, or proctoscope.
• Anesthesia: General anesthesia or deep sedation to ensure the patient is unconscious and pain-free.

Duration

The procedure typically takes about 30-60 minutes.

Setting

This procedure is usually performed in a hospital, outpatient surgical center, or specialized clinic.

Personnel

• Surgeon or gastroenterologist.
• Nurse or medical assistant.
• Anesthesiologist or nurse anesthetist.

Risks and Complications

• Common Risks: Minor bleeding, temporary discomfort.
• Rare Risks: Infection, bowel perforation, anesthesia complications.
• Management: Antibiotics for infection, monitoring for complications, immediate medical intervention if severe issues arise.

Benefits

• Expected Benefits: Immediate relief from discomfort, resolution of constipation or blockage.
• Timeline: Benefits are typically realized immediately after the procedure.

Recovery

• Post-Procedure Care: Observation until anesthesia wears off, hydration, gradual reintroduction of foods.
• Recovery Time: Most patients can resume normal activities within a day but should avoid strenuous activity for a few days.
• Follow-up: Follow-up appointment to check for any complications and discuss long-term bowel management strategies.

Alternatives

• Non-Surgical Options: Laxatives, enemas, manual disimpaction without anesthesia.
• Pros and Cons: Less invasive options may be less effective for severe cases; non-surgical methods might cause discomfort without anesthesia.

Patient Experience

• During Procedure: Under anesthesia, patients will not feel any pain or discomfort.
• After Procedure: Some mild soreness or discomfort in the rectal area, managed with pain relief medications and rest. Instructions will be provided to ensure comfortable and safe recovery at home.