Operation

Exploratory laparotomy with lysis of adhesions.

Description

Bringing this omentum up, there were some adhesions to the anterior abdominal wall from a prior open cholecystectomy site. This was dissected free with electrocautery a bit. I was able to elevate the right lateral abdominal wall and indeed a loop of the small bowel was ischemic in nature. Further palpation found a band from the omentum to the lateral side pelvic wall. This was freed with blunt dissection. Good hemostasis was noted. The bowel was delivered up into the incision and inspected. There was a mesentery that was a little cyanotic. The areas of the small bowel where the band of adhesion was constricting the bowel were inspected. There was no cyanosis or no areas of perforation. I then placed the bowel back into anatomical position and we waited 15 minutes. The bowel did pink up. There was still a little bit of cyanotic areas but the bowel wall felt thick and not thin/ suspicious for a perforation. There are no obvious perforations presently. The bowel was placed back into its anatomical position.

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