One of my surgeons performed a bowel resection and administered fluorescein to the patient. Using the Woods Lamp he checked the vascular viability of the bowels. I am at a loss as to how or if I should code for this..
Here is an excerpt from the Op Note:
All bleeding was controlled as we entered the abdomen. Immediately on evisceration, we found a single band of adhesion from the cecum to the left pelvic sidewall. This would be clamped, divided, and tied. We then untwisted the mesentery of the small bowel, and there was an obvious clear-cut demarcation with significant vascular compromise. This would be allowed to return to the abdomen and we would copiously irrigate with multiple liters of warm saline. After appropriate time, this was re-examined and although there
appeared to be some perfusion, there was still significant question about the compromise including the venous congestion.
At this point, fluorescein was administered and using the Woods lamp, close examination revealed excellent blood supply to the remaining small bowel except for a segment that had been clearly demarcated visually which would be at about the mid ileum itself. This would be about 3 to 4 feet in length. This did not appear to be acceptable for resection. Therefore we would repair for a small bowel resection.
All I can find for fluorescein is either opthemologic or for a skin graft..
Any help is appreciated!!
Thanks!!
Nicole
Here is an excerpt from the Op Note:
All bleeding was controlled as we entered the abdomen. Immediately on evisceration, we found a single band of adhesion from the cecum to the left pelvic sidewall. This would be clamped, divided, and tied. We then untwisted the mesentery of the small bowel, and there was an obvious clear-cut demarcation with significant vascular compromise. This would be allowed to return to the abdomen and we would copiously irrigate with multiple liters of warm saline. After appropriate time, this was re-examined and although there
appeared to be some perfusion, there was still significant question about the compromise including the venous congestion.
At this point, fluorescein was administered and using the Woods lamp, close examination revealed excellent blood supply to the remaining small bowel except for a segment that had been clearly demarcated visually which would be at about the mid ileum itself. This would be about 3 to 4 feet in length. This did not appear to be acceptable for resection. Therefore we would repair for a small bowel resection.
All I can find for fluorescein is either opthemologic or for a skin graft..
Any help is appreciated!!
Thanks!!
Nicole
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