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

CPT4 code

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.

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