Shirleybala
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Hello:
How to code balloon angioplasty uretero-enteric anastomosis.
61-year-old female status post Indiana pouch creation status post
left nephroureteral catheter referred for dilatation of the
ureteral anastomotic stricture and exchange of the nephroureteral
stent placement.
Procedure:
Following informed consent the patient was placed in the prone
position and the right flank prepped and draped in a sterile
fashion. Intravenous versed and Fentanyl were administered for
conscious sedation. Physiologic monitoring was performed
throughout the procedure. Intravenous antibiotics were
administered prior to the procedure.
The previously placed catheter was prepped and draped in a sterile
fashion. Contrast was injected and digital images were obtained.
The catheter was exchanged over a guidewire for a 7-French
vascular sheath. Contrast was injected and imaging of the distal
left ureteral enteric anastomosis was performed. These images
demonstrate a moderate-grade narrowing of the ureteral enteric
anastomosis. This narrowing was dilated to 8 mm with a prolonged
inflation.
The tract was dilated to 10 F and an 10F, 24 cm long
nephroureteral catheter placed with its distal loop forming in the
bladder and its locking loop formed in the dilated right renalpelvis.
The catheter was secured to the skin with adhesives and attached
to gravity drainage. The patient tolerated the procedure well and
left the department in satisfactory condition.
Findings:
There is high grade narrowing of left uretero-enteric anastomosis.
This was treated with balloon angioplasty a 8 mm and then stented
with a 10-French nephroureteral catheter placed as described
above.
Impression:
1. Moderate grade distal left uretero-enteric stricture treated
with balloon dilatation to 8mm .
2. Exchange of previously placed 8-French nephroureteral catheter
for a new 10-French, 24-cm long nephro ureteral catheter.
How to code balloon angioplasty uretero-enteric anastomosis.
61-year-old female status post Indiana pouch creation status post
left nephroureteral catheter referred for dilatation of the
ureteral anastomotic stricture and exchange of the nephroureteral
stent placement.
Procedure:
Following informed consent the patient was placed in the prone
position and the right flank prepped and draped in a sterile
fashion. Intravenous versed and Fentanyl were administered for
conscious sedation. Physiologic monitoring was performed
throughout the procedure. Intravenous antibiotics were
administered prior to the procedure.
The previously placed catheter was prepped and draped in a sterile
fashion. Contrast was injected and digital images were obtained.
The catheter was exchanged over a guidewire for a 7-French
vascular sheath. Contrast was injected and imaging of the distal
left ureteral enteric anastomosis was performed. These images
demonstrate a moderate-grade narrowing of the ureteral enteric
anastomosis. This narrowing was dilated to 8 mm with a prolonged
inflation.
The tract was dilated to 10 F and an 10F, 24 cm long
nephroureteral catheter placed with its distal loop forming in the
bladder and its locking loop formed in the dilated right renalpelvis.
The catheter was secured to the skin with adhesives and attached
to gravity drainage. The patient tolerated the procedure well and
left the department in satisfactory condition.
Findings:
There is high grade narrowing of left uretero-enteric anastomosis.
This was treated with balloon angioplasty a 8 mm and then stented
with a 10-French nephroureteral catheter placed as described
above.
Impression:
1. Moderate grade distal left uretero-enteric stricture treated
with balloon dilatation to 8mm .
2. Exchange of previously placed 8-French nephroureteral catheter
for a new 10-French, 24-cm long nephro ureteral catheter.