Question Answered step-by-step Case 14 PREOPERATIVE DIAGNOSIS: Right testicular torsion… Case 14PREOPERATIVE DIAGNOSIS: Right testicular torsionPOSTOPERATIVE DIAGNOSIS: Torsion of right testicular appendixOPERATION PERFORMED: Exploration of right testicle with excision of right testicular appendix.OPERATIVE NOTE: With the patient under satisfactory general anesthesia, the scrotum was prepped and draped in the usual sterile manner. An incision was made in the hemi-scrotum, and the testicle was extruded through the incision. The appendix testis was cross clamped and excised. The base was tied with a simple 3-0 Chromic tie. The testicle was fixed in the scrotum with 1 suture of 4-0 Chromic suture extending through the tunica albuginea and into the scrotum. The testicle was returned to the scrotum. The incision was closed with interrupted 4-0 Chromic suture. Neosporin was applied to the incision. The patient was discharged to the Recovery Room in good condition.CPT Code(s): ICD-10-CM Code(s): PREOPERATIVE DIAGNOSIS: Bilateral hydrocelesPOSTOPERATIVE DIAGNOSIS: Bilateral hydrocelesOPERATION PERFORMED: Bilateral HydrocelectomyANESTHESIA: GeneralCLINICAL HISTORY: This is a 2-year-old boy with an obvious hydrocele. The left cord was thickened.OPERATIVE FINDINGS: Bilateral communicating hydroceles.PROCEDURE: With the patient under general anesthesia, the abdomen and groin were prepped and draped in a sterile manner. A transverse incision was made over the right inguinal canal. The external oblique fascia was opened in the direction of its fibers through the external ring. The cord was brought up into the wound and the cord was explored. The hydrocele was identified and separated from the vas and vessels. It was clamped and divided and traced proximally to the internal ring where it was twisted and triply ligated with 2-0 Ethibond sutures. The distal sac was subtotally excised down to the testicle using electrocautery. The external oblique fascia was closed with interrupted 4-0 Vicryl sutures. Scarpa’s fascia was closed with interrupted 4-0 Vicryl sutures and the skin was closed with interrupted 5-0 Vicryl in a subcuticular fashion and reinforced with Mastisol and Steri-strips. The left side was explored through a similar incision. The external oblique fascia was identified, and the cord was seen and explored. A small communicating hydrocele was identified, separated from the vas and vessels, and was traced proximally to the internal ring where it was triply ligated with 3-0 Ethibond suture. The distal hydrocele was then taken down to the testicle and removed. The external oblique fascia was closed with interrupted 3-0 Vicryl sutures, the Scarpa’s fascia was closed with interrupted 4-0 Vicryl sutures, and the skin was closed with interrupted 5-0 Vicryl in a subcuticular fashion and reinforced with Mastisol and Steri-strips. Blood loss was minimal. There were no operative complications. The child tolerated the procedure well.CPT Code(s): ICD-10-CM Code(s): Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
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