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Petersen's defect

  1. #1
    Default Petersen's defect
    Medical Coding Books
    I can't find the ICD-9 for this & am new to gastro/bariatrics.

    Also the doc did a "laparoscopy & internal hernia repair" which was the Petersen's defect. I can't find this code anywhere!!

  2. #2
    Default Petersens defect
    I come up with 553.8 hernia of other specified sites, and for the lap procedure, I get an unlisted code 49659, not real sure about that but can't find anything else for internal. But here's what's said about Petersen's hernia:

    In the undisturbed abdominal cavity, the transverse colon acts as a partition between the stomach above and the small intestine below. Once a gastroenteric anastomosis is constructed, a potential space for internal herniation is created posterior to the limbs of the small intestine. The risk for herniation exists whether the anastomosis is ante- or retrocolic and whether the gastrojejunostomy is nonresectional or performed after a partial or subtotal gastrectomy.

    In 1900, the European literature included a report by Petersen on the occurrence of an internal hernia after partial gastrectomy and gastrojejunostomy.1 Soon thereafter, similar reports appeared in the American literature. Throughout the greater part of the 20th century, there were frequent updates on Petersen's hernia, and by 1974, 178 cases had been reported.2 This span of about 75 years was the era when peptic ulcer disease and its complications were common and every general surgeon was familiar with performing antrectomy, truncal vagotomy, gastrojejunostomy, or subtotal gastrectomy in conjunction with gastrojejunostomy, since these were the most popular and effective treatments for chronic peptic ulcer disease. Although Petersen's hernia was rare despite the millions of gastric resections that had been performed, it was an appreciated entity, and several authors, including my former professor Dr. Alfred Markowitz, reported on its clinical presentations and the need to have a high index of suspicion because immediate surgery could be life-saving.3-5

  3. #3
    Final Diagnosis: Internal hernia (Petersen's) status post Roux-en-y gastric bypass (RYGB) surgery = 553.8

    Petersen's internal hernia occurs posterior to a gastroenteric anastomosis.

    Hope this helps!!!


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