You Be the Coder: Graham Patch. General Surgery Coding Alert. What is the correct code for a Graham patch omentoplasty used to repair a perforated duodenal ulcer? Laparoscopic omental patch repair with thorough peritoneal wash. Laparoscopic repair of perforted duodenal ulcer has many advantages as less. Simple omental patch repair is a quick procedure but results in. Omental Patch Repair for Duodenal Ulcer Perforation – General Surgery Topics. Omental Patch Repair for Duodenal. Ulcer Perforation. One common complication of duodenal ulcer is perforation. Typicallyan ulcer which is located in the anterior wall of the duodenum perforates andone is located in the posterior wall bleeds. Perforation can lead on to peritonitis. Hence it is a surgicalemergency. The type of facies ( facial appearance) we get in a patient withterminal stage of peritonitis is called Hippocratic facies. The diagnosis of perforation peritonitis can be made from the clinical examination. Therewill be abdominal rigidity on palpation. Abdominal rigidity is due to theinvoluntary contraction of abdominal wall muscles.
The investigation of choice to diagnose a case of perforationperitonitis is a plain radio- graph of the abdomen in erect posture. The characteristic finding in a plain radio- graph is free gas under the diaphragm. The treatment of a perforated duodenal ulcer is closure of theperforation with a patch of the omentum. This is known as Omental patch repair. An abdominal lavage with warm Normal saline or Ringer Lactate is mandatory afterthe procedure.
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