Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy
CPT4 code
Name of the Procedure:
Suture of Large Intestine (Colorrhaphy) for Perforated Ulcer, Diverticulum, Wound, Injury, or Rupture (Single or Multiple Perforations); Without Colostomy.
Summary
Colorrhaphy is a surgical procedure used to repair perforations in the large intestine caused by ulcers, diverticula, injuries, or ruptures. During the operation, the surgeon stitches the damaged areas to restore the integrity of the intestinal wall without the need for a colostomy.
Purpose
The purpose of colorrhaphy is to close perforations in the large intestine to prevent leakage of intestinal contents into the abdominal cavity, which can cause severe infection and other complications. The goal is to restore the normal function of the intestine and ensure proper healing.
Indications
- Perforated bowel due to ulcers or diverticula
- Traumatic injury to the large intestine
- Spontaneous rupture of the large intestine
- Presence of single or multiple perforations
Preparation
- Patients may need to fast for 8 hours prior to surgery.
- Discontinue certain medications as advised by the doctor.
- Undergo pre-operative assessments including blood tests, imaging studies (CT scan, X-ray), and physical examination.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free during the surgery.
- Incision: A surgical incision is made in the abdomen to access the large intestine.
- Identification of Perforations: The surgeon locates and assesses the perforations.
- Suturing: The perforated areas are carefully stitched (sutured) to close the openings.
- Inspection: The entire intestine is inspected for any additional perforations or damage.
- Closure: The abdominal incision is closed with sutures or staples.
Duration
The procedure typically takes 2 to 4 hours, depending on the extent of the perforations and the patient's overall condition.
Setting
The procedure is performed in a hospital operating room.
Personnel
- General Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Common Risks: Infection, bleeding, reaction to anesthesia
- Rare Risks: Injury to nearby organs, leakage at the suture site, prolonged bowel dysfunction
- Management: Post-surgery antibiotics, additional surgery if complications arise
Benefits
- Immediate repair of intestinal perforations
- Prevention of severe infection and other life-threatening complications
- Restoration of normal bowel function over time
Recovery
- Hospital stay of 3 to 7 days post-surgery
- Pain management with medications
- Gradual return to normal diet and activities
- Follow-up appointments for monitoring recovery and removal of sutures/staples if necessary
Alternatives
- Conservative Management: Observation and antibiotics for minor perforations
- Colostomy: Temporary or permanent diversion of the intestine via a colostomy bag (less preferable due to lifestyle changes)
Patient Experience
- During the procedure: Patient is under general anesthesia and will not feel anything.
- After the procedure: Pain and discomfort managed with medication, gradual improvement in symptoms, restrictions on physical activity, and dietary adjustments.