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Ligation, major artery (eg, post-traumatic, rupture); abdomen
CPT4 code
Name of the Procedure:
Ligation of a Major Artery in the Abdomen (Post-traumatic or Rupture)
Summary
In this procedure, a surgeon ties off a major artery within the abdomen to stop severe bleeding, typically after an injury or due to a rupture. This is often an emergency surgery aimed at saving the patient's life.
Purpose
- Medical Condition: This procedure addresses severe internal bleeding caused by trauma or arterial rupture in the abdomen.
- Goals/Outcomes: The primary goal is to control hemorrhage, stabilize the patient's condition, and prevent further blood loss or shock.
Indications
- Massive internal bleeding in the abdominal cavity.
- Rupture of a major abdominal artery.
- Trauma to the abdomen causing arterial damage.
- Signs of hemorrhagic shock, such as rapid heartbeat, low blood pressure, and pallor.
Preparation
- Pre-Procedure Instructions: Fasting is required for several hours before surgery.
- Medication Adjustments: Blood-thinning medications may need to be paused under medical advice.
- Diagnostic Tests: Imaging studies like CT scans or ultrasound to locate the bleeding and assess damage.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made in the abdomen to access the bleeding artery.
- The surgeon identifies the damaged artery and uses a special surgical clamp and sutures to tie off or "ligate" the artery.
- Hemostasis is ensured, and the wound is cleaned and closed.
- The patient is monitored closely for stabilization.
Tools/Equipment: Surgical clamps, sutures, scalpel, imaging devices. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and free of pain during the procedure.
Duration
The procedure typically takes around 1-3 hours, depending on the complexity and extent of the injury.
Setting
The surgery is performed in a hospital operating room, often in an emergency or trauma center setting.
Personnel
- Surgeon: Performs the ligation.
- Anesthesiologist: Manages anesthesia.
- Surgical Nurses: Assist with the procedure.
- Radiologist: May be involved for imaging guidance.
Risks and Complications
- Common Risks: Infection, blood clots, and bleeding.
- Rare Risks: Damage to surrounding organs, failure to control bleeding, and adverse reactions to anesthesia.
Benefits
- Expected Benefits: Immediate control of bleeding, stabilization of the patient's condition, and preservation of life.
- Realization Time: Benefits are typically realized immediately post-surgery as bleeding is controlled.
Recovery
- Post-Procedure Care: Close monitoring in an intensive care unit (ICU), pain management, and possibly blood transfusions if necessary.
- Recovery Time: Initial recovery in the hospital usually lasts 1-2 weeks, with several weeks of rest and limited activity at home.
- Follow-Up: Regular follow-up appointments to monitor healing and check for complications.
Alternatives
- Other Options: Endovascular repair (minimally invasive), embolization (blocking the artery with coils or particles).
- Pros and Cons: Less invasive alternatives may have faster recovery times but may not be feasible or as effective in emergency situations.
Patient Experience
- During the Procedure: The patient will be under general anesthesia and should not feel any pain or discomfort.
- After the Procedure: Pain at the incision site, temporary soreness, and limited mobility. Pain management includes medications and supportive care for comfort.