Hi all,
Need help regarding post-op inguinal hematoma after hernia repair. Any ideas? 10140 vs 35860? I feel this is more involved than a simple 10140, and I'm having a hard time getting past "extremity" for 35860. Any help would be greatly appreciated!! TIA
• Postoperative Diagnosis: Right inguinal surgical site hematoma
• Procedure(s) Performed: Right inguinal exploration and evacuation of hematoma
• Anesthesia: general
• Findings: diffuse ooze from surgical surface, no single active bleeder, clots from surgical site
and scrotum evacuated
• Pathology: none
• History: Patient developed inguinal area hematoma after discharge and came to ED where a
decision was made to explore the surgical site to evacuate hematoma and control bleeding
source.
• Procedure in Detail: Patient was brought to OR by on call attending and we joined at
the time of intubation. General endotracheal anesthesia was induced and the groin and lower
abdomen was prepped and draped in the usual sterile fashion. Prior incision was opened until
external obl ique was reached. In this area there were clots which were evacuated. External
oblique closure was opened again and wound was irrigated and clots removed. Spermatic cord
was identified and found to be in healthy condition without bleeding. Floor was inspected and
mesh and deep ring repair were also intact. There was no bleeding from the deep ring or floor.
Scrotum was compressed to evacuate as much hematoma as possible via external ring. Further
irrigation and suction was performed and no bleeders were ident ified. All adipose t issue and raw
surfaces were cauterized again. Valsalva was performed and no active bleeders were found.
Tisseel was placed in surgical field. Next, external aponeurosis was closed with space for
external ring. Arista powder was also used. Wound was closed in multiple layers using 3-0
Vicryl. Staples were used for skin and vac system was placed. Both testes were in correct
position. The patient was extubated without complications and transferred to the ICU upon
completion of the procedure in stable condition . Disposition is stable. All sponge counts,
instruments, and needle counts were correct at the end of the case.
We were present throughout the entire procedure. There were no intraoperative complications.
Need help regarding post-op inguinal hematoma after hernia repair. Any ideas? 10140 vs 35860? I feel this is more involved than a simple 10140, and I'm having a hard time getting past "extremity" for 35860. Any help would be greatly appreciated!! TIA
• Postoperative Diagnosis: Right inguinal surgical site hematoma
• Procedure(s) Performed: Right inguinal exploration and evacuation of hematoma
• Anesthesia: general
• Findings: diffuse ooze from surgical surface, no single active bleeder, clots from surgical site
and scrotum evacuated
• Pathology: none
• History: Patient developed inguinal area hematoma after discharge and came to ED where a
decision was made to explore the surgical site to evacuate hematoma and control bleeding
source.
• Procedure in Detail: Patient was brought to OR by on call attending and we joined at
the time of intubation. General endotracheal anesthesia was induced and the groin and lower
abdomen was prepped and draped in the usual sterile fashion. Prior incision was opened until
external obl ique was reached. In this area there were clots which were evacuated. External
oblique closure was opened again and wound was irrigated and clots removed. Spermatic cord
was identified and found to be in healthy condition without bleeding. Floor was inspected and
mesh and deep ring repair were also intact. There was no bleeding from the deep ring or floor.
Scrotum was compressed to evacuate as much hematoma as possible via external ring. Further
irrigation and suction was performed and no bleeders were ident ified. All adipose t issue and raw
surfaces were cauterized again. Valsalva was performed and no active bleeders were found.
Tisseel was placed in surgical field. Next, external aponeurosis was closed with space for
external ring. Arista powder was also used. Wound was closed in multiple layers using 3-0
Vicryl. Staples were used for skin and vac system was placed. Both testes were in correct
position. The patient was extubated without complications and transferred to the ICU upon
completion of the procedure in stable condition . Disposition is stable. All sponge counts,
instruments, and needle counts were correct at the end of the case.
We were present throughout the entire procedure. There were no intraoperative complications.