AAPC - Back to school
Results 1 to 3 of 3

Thread: Resection of mesenteric mass

  1. #1

    Default Resection of mesenteric mass

    AAPC: Back to School
    ACK! I keep confusing myself with this one. Just hoping that I could get someone else's input. Thanks for checking it out!

    Mesenteric mass.

    Mass of omentum and transverse mesocolon.

    1. Laparoscopy with open laparotomy.
    2. Pelvic exploration.
    3. Lysis of adhesions.
    4. Resection of mesenteric mass.

    The patient was taken to the operating room after adequate general anesthesia. The patient as prepped with DuraPrep and draped sterilely. The initial incision was made in the infraumbilical region with a #15 blade and carried down through the subcutaneous tissues. The Veress needle was introduced. The abdomen was insufflated to 15 mmHg pressure with CO2. The 5 millimeters OptiView port was passed without difficulty. Circumferential view of the peritoneal cavity revealed no underlying bowel or vascular injuries. There is evidence of surgery in the pelvis. The 5 millimeter ports were placed in the right and then left rectus muscle. The sigmoid colon was adherent to what appeared to be a mass in the right pelvic wall. This was carefully dissected using laparoscopy. However, it became clear that the degree of adherence was something that should be addressed with open surgery. The lower midline incision was then made with a #15 blade and carried down through the subcutaneous tissues from the symphysis pubis cephalad. The peritoneal cavity was entered. It was apparent that there was a mass in the right pelvic area which was well-adherent to the sigmoid colon. Utilizing careful dissection I was able to free this from the sigmoid colon. Ultimately I was able to mobilize the tissue enough to realize that this was actually residual from her supracervical hysterectomy and that this was apparently normal residual cervix. The possibility that her pain was related to the adherence of the cuff to the sigmoid colon was entertained.

    Further exploration was performed. The small bowel was run proximally from the ileocecal valve to the jejunum. No masses were identified. The posterior pelvis and abdomen was unremarkable. No significant adenopathy was appreciated. No mass was noted. No masses were appreciated in the mesentery of the small bowel. The omentum was then pulled down and above the level of the transverse colon a 2.3 centimeter mass was appreciated. It was bi-lobed the same as the mass noted on previous scans. It was significantly smaller. The lesion appeared to have a somewhat hemorrhagic appearance possibly lymph node or other. The mass was resected after passing clamps and ligating with 2-0 silk suture. Further exploration revealed no other significant lesions. This was passed off as specimen. The lap count was noted to be correct. The omentum was then tucked down into the pelvis posterior to the cuff of the supracervical hysterectomy. The midline incision was then closed with running double-stranded #1 PDS suture, 2-0 Vicryl was utilized in the subcutaneous tissue and clips applied to the skin. The estimated blood loss was perhaps 50 mL. The patient tolerated the procedure. Pathology is pending at this time.

    BTW: Path came back as benign hemangioma.

  2. #2
    Join Date
    Apr 2007


    just report 49203...if LOA was documented as extensive for over 1 hr, you can mod 22 49203.

  3. #3
    Join Date
    Apr 2007



Similar Threads

  1. Resection Endocervical Mass
    By kerri0402 in forum OB/GYN
    Replies: 0
    Last Post: 08-16-2012, 10:33 AM
  2. Replies: 0
    Last Post: 07-26-2012, 01:32 PM
  3. Replies: 2
    Last Post: 10-07-2010, 06:54 AM
  4. Resection of paravertebral mass
    By GIBBERS in forum Cardiovascular Thoracic
    Replies: 3
    Last Post: 08-25-2010, 09:17 AM
  5. Code for biopsy of mesenteric mass
    By HILLIC in forum General Surgery
    Replies: 1
    Last Post: 11-14-2008, 01:24 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.