A cecal volvulus is the rotation or torsion of a mobile cecum and ascending colon, which causes approximately 1 to 3 percent of all large bowel obstructions [1-3]. If untreated, cecal volvulus can progress to bowel ischemia, necrosis, or perforation [4-8].
K63. 89 Other specified diseases of intestine - ICD-10-CM Diagnosis Codes.
ICD-10 Code for Other intestinal obstruction- K56. 69- Codify by AAPC.
Z48. 815 - Encounter for surgical aftercare following surgery on the digestive system | ICD-10-CM.
Z12. 11: Encounter for screening for malignant neoplasm of the colon.
Benign carcinoid tumor of the cecum D3A. 021 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM D3A. 021 became effective on October 1, 2021.
Definition of volvulus : a twisting of the intestine upon itself that causes obstruction.
If the physician documents a large intestine obstruction for example, and does not find a specific cause, then the unspecified code, K56. 609, Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction is assigned.
Pathophysiology — Sigmoid volvulus occurs when an air-filled loop of the sigmoid colon twists about its mesentery. Obstruction of the intestinal lumen and impairment of vascular perfusion occur when the degree of torsion exceeds 180 and 360 degrees, respectively [24].
Total colectomy involves removing the entire colon. Partial colectomy involves removing part of the colon and may also be called subtotal colectomy. Hemicolectomy involves removing the right or left portion of the colon.
Acquired absence of other specified parts of digestive tract The 2022 edition of ICD-10-CM Z90. 49 became effective on October 1, 2021.
ICD-10 code Z48. 816 for Encounter for surgical aftercare following surgery on the genitourinary system is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Pneumatosis intestinalis (PI) refers to the presence of gas within the wall of the small or large intestine. Intramural gas can also affect the stomach, but this condition is referred to as gastric pneumatosis [1].
5.3 Pneumatosis Cystoides Intestinalis Pneumatosis cystoides intestinalis, or air in the bowel wall, has been reported in SSc [73]. In this setting, it is a benign condition of no particular significance, although it may indicate more advanced disease.
ICD-10-CM Code for Abnormal findings on diagnostic imaging of other specified body structures R93. 8.
Ultrasonography of Abdomen ICD-10-PCS BW40ZZZ is a specific/billable code that can be used to indicate a procedure.
The 2022 edition of ICD-10-CM C18.0 became effective on October 1, 2021.
Cancer of the cecum. Cancer of the cecum, adenocarcinoma. Primary malignant neoplasm of cecum. Primary malignant neoplasm of ileocecal valve. Clinical Information. A primary or metastatic malignant neoplasm that affects the cecum. Representative examples include carcinoma, lymphoma, and sarcoma.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.
Cecal volvulus accounts for ~10% of all intestinal volvuluses , and generally occur in somewhat younger patients than with a sigmoid volvulus, most being 30-60 years old. There are two predisposing factors that are important for the development of a cecal volvulus: 1 developmental failure of peritoneal fixation allows the proximal colon to be free and mobile: this occurs in 11-25% of the population 2 restriction of the bowel at a fixed point within the abdomen, acting as a fulcrum for rotation, e.g. adhesion, abdominal mass, scarring from calcified lymph nodes
A specific CT sign for volvulus is the whirl sign , which has been described in volvulus of the midgut, cecum, and sigmoid colon 3. The whirl is composed of spiralled loops of collapsed cecum and sigmoid colon. Low-attenuating fatty mesentery with enhancing engorged vessels radiate from the twisted bowel.
There is a variant of cecal volvulus termed a " cecal bascule " that occurs when the cecum folds anteriorly without any torsion. A cecal bascule is often seen as a dilated loop in the mid-abdomen and although there is an association with prior surgery, adhesions, and bands they are not essential for a volvulus to occur.
The degree of cecal rotation can even be predicted by the tightness of the whirl. A recently described sign of a complete volvulus is the X-marks-the-spot sign , referring to the crossing loops of bowel at the site of the transition.
There are two predisposing factors that are important for the development of a cecal volvulus: developmental failure of peritoneal fixation allows the proximal colon to be free and mobile: this occurs in 11-25% of the population.
On abdominal radiographs, there is marked distension of a loop of large bowel with its long axis extending from the right lower quadrant to the epigastrium or left upper quadrant. The general caliber for the cecum is < 9 cm (see the 3-6-9 rule ). Depending on the initial bowel position and the length of mobile right colon, the distended cecum may be seen anywhere in the abdomen.
The other half of patients have what is known as the loop type of cecal volvulus, in which the cecum both twists and inverts, occupying the left upper quadrant of the abdomen. The terminal ileum is usually twisted along with the cecum. Visualization of a gas-filled appendix confirms the diagnosis.