Cpt egd with fistula closure

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Cpt egd with fistula closure

CASE REPORT A 47-year-old man with history of chronic pancreatitis, alcoholism and Billroth II gastrojejunostomy for perforated peptic ulcer presented with chronic diarrhea and severe weight loss of 32-kg over a 1 year-period. The diarrhea was watery and occurred up to 12 times per day, being worse after eating. His physical examination was remarkable for cachexia, his weight was 40 kg, his height was 170 cm (body mass index = 12.8). The laboratory data were remarkable for hypoalbuminemia (1.8 g/dL) and decreased hemoglobin (11 g/dL). An esophagogastroduodenoscopy (EGD) showed a clean based ulceration at the anastomosis and patent lumen to both the afferent and efferent limbs (Figure. 1B ). Insertion of the scope through this orifice lead to the colon. The patient was placed on bowel rest, NPO, total parenteral nutrition. Due to the patient's poor medical status no surgical intervention could be attempted to close the defect. The patient underwent a full GI evaluation (pananedoscopy) to exclude a malignancy or inflammatory bowel diseases leading to fistula formation. An upper GI series using barium clearly demonstrated a communication between the stomach and the colon. A colonoscopy revealed a normal colon mucosa, but no clear fistula opening could be detected. Repeat EGD disclosed the three openings at the gastrojejunal (Billroth II) anastomosis. Both the afferent and efferent limbs were patent and had normal mucosa. The gastrocolic fistula measured about 10-12 mm in diameter (Figure. Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences..

Sep 13, 2017. Hi , Can anybody please advise CPT code for EGD with closure of esophagocutaneous fistula done endoscopically. Aug 16, 2013. A colonoscopy revealed a normal colon mucosa, but no clear fistula opening could be detected. Repeat EGD disclosed the three openings at . Endoscopic Fistula Closure? An endoscopic fistula closure is a safe way to close gastric, duodenal, and colonic perforations. About fistula closure: A fistula is ..

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