ICD-10: K55.02

Acute infarction of the small intestine, classified under ICD-10 code K55.02, is a serious medical condition characterized by the sudden loss of blood supply to a portion of the small intestine, leading to tissue death (necrosis). This condition can result from various underlying causes, including vascular occlusion, embolism, or thrombosis, and it requires prompt medical intervention to prevent severe complications.

Clinical Description

Pathophysiology

The small intestine is supplied by branches of the mesenteric arteries, which are crucial for delivering oxygenated blood. An acute infarction occurs when there is a sudden interruption of this blood flow, often due to:

• Embolism: A blood clot or other debris travels through the bloodstream and lodges in a mesenteric artery.
• Thrombosis: A clot forms directly in the mesenteric artery, often due to atherosclerosis or other vascular diseases.
• Non-occlusive ischemia: Conditions such as low blood pressure or shock can lead to inadequate blood flow without a physical blockage.

Symptoms

Patients with acute infarction of the small intestine may present with a range of symptoms, including:

• Severe abdominal pain: Often sudden and intense, localized to the area of the affected intestine.
• Nausea and vomiting: These symptoms may occur as the body reacts to the pain and the underlying ischemia.
• Diarrhea or bloody stools: As the intestinal tissue becomes necrotic, bleeding may occur, leading to the presence of blood in the stool.
• Fever: A systemic response to the necrotic tissue and potential infection.

Diagnosis

Diagnosis typically involves a combination of clinical evaluation and imaging studies. Key diagnostic tools include:

• CT scan of the abdomen: This imaging modality is particularly useful for visualizing the blood supply to the intestines and identifying areas of infarction.
• Ultrasound: Can be used to assess blood flow and detect abnormalities in the mesenteric vessels.
• Angiography: In some cases, this may be performed to visualize the blood vessels directly and identify blockages.

Treatment

Management of acute infarction of the small intestine often requires urgent surgical intervention. Treatment options may include:

• Surgical resection: Removal of the necrotic segment of the intestine is often necessary to prevent further complications, such as perforation or peritonitis.
• Restoration of blood flow: In cases where the infarction is due to a reversible cause, such as a thrombus, procedures to restore blood flow may be performed.
• Supportive care: This includes fluid resuscitation, pain management, and monitoring for complications.

Conclusion

ICD-10 code K55.02 is critical for accurately documenting and billing for cases of acute infarction of the small intestine. Given the potential for severe complications, timely diagnosis and intervention are essential for improving patient outcomes. Understanding the clinical presentation, diagnostic methods, and treatment options is vital for healthcare providers managing this serious condition.

The ICD-10 code K55.02 refers to "Acute infarction of small intestine," a serious medical condition characterized by the sudden loss of blood supply to a portion of the small intestine, leading to tissue death. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management.

Clinical Presentation

Acute infarction of the small intestine typically presents with a range of symptoms that can vary in intensity depending on the extent of the infarction and the underlying cause. The clinical presentation may include:

• Severe Abdominal Pain: Patients often report sudden, severe abdominal pain that may be localized or diffuse. The pain is typically described as sharp or cramp-like and may worsen over time.
• Nausea and Vomiting: Accompanying the abdominal pain, patients frequently experience nausea and may vomit, which can be bilious if the obstruction is significant.
• Diarrhea: Some patients may present with diarrhea, which can be bloody if the infarction leads to ischemic colitis or necrosis of the intestinal wall.
• Abdominal Distension: The abdomen may appear distended due to gas accumulation or fluid buildup, indicating a potential obstruction or ileus.
• Fever: A low-grade fever may be present, reflecting an inflammatory response to tissue necrosis.

Signs

Upon physical examination, healthcare providers may observe several signs indicative of acute intestinal infarction:

• Tenderness: The abdomen is often tender to palpation, particularly in the area corresponding to the affected segment of the small intestine.
• Guarding and Rigidity: Patients may exhibit involuntary guarding or rigidity of the abdominal muscles, suggesting peritoneal irritation.
• Bowel Sounds: Auscultation may reveal decreased or absent bowel sounds, indicating a potential ileus or obstruction.
• Signs of Shock: In severe cases, patients may show signs of hypovolemic shock, including tachycardia, hypotension, and altered mental status.

Symptoms

The symptoms of acute infarction of the small intestine can be quite severe and may evolve rapidly. Key symptoms include:

• Acute Onset of Pain: The sudden onset of severe abdominal pain is often the first symptom that prompts patients to seek medical attention.
• Changes in Bowel Habits: Patients may notice changes in their bowel habits, including diarrhea or constipation, depending on the severity of the infarction.
• Dehydration: Due to vomiting and diarrhea, patients may become dehydrated, leading to symptoms such as dry mouth, decreased urine output, and dizziness.

Patient Characteristics

Certain patient characteristics may predispose individuals to acute infarction of the small intestine:

• Age: Older adults are at a higher risk due to age-related vascular changes and comorbidities.
• Vascular Disease: Patients with a history of cardiovascular disease, peripheral artery disease, or atherosclerosis are more susceptible to mesenteric ischemia.
• Coagulation Disorders: Conditions that affect blood clotting, such as thrombophilia, can increase the risk of vascular occlusion leading to infarction.
• Previous Abdominal Surgery: Individuals with a history of abdominal surgeries may have adhesions that can compromise blood flow to the intestines.
• Chronic Conditions: Patients with chronic conditions such as diabetes or inflammatory bowel disease may also be at increased risk.

Conclusion

Acute infarction of the small intestine is a critical condition that requires prompt recognition and intervention. The clinical presentation is characterized by severe abdominal pain, nausea, vomiting, and signs of peritoneal irritation. Understanding the associated symptoms and patient characteristics can aid healthcare providers in diagnosing and managing this potentially life-threatening condition effectively. Early intervention is essential to prevent complications such as bowel necrosis and sepsis, which can arise from delayed treatment.

The ICD-10 code K55.02 refers specifically to "Acute infarction of small intestine." This condition is categorized under the broader classification of vascular disorders of the intestine, which is represented by the K55 code range. Here are some alternative names and related terms associated with K55.02:

Alternative Names

1. Small Intestinal Infarction: This term is often used interchangeably with acute infarction of the small intestine, emphasizing the location of the infarction.
2. Ischemic Enteritis: This term refers to inflammation of the intestine due to inadequate blood supply, which can lead to infarction.
3. Mesenteric Ischemia: While this term generally refers to reduced blood flow to the mesentery (the tissue that attaches the intestines to the abdominal wall), it can result in acute infarction of the small intestine if not addressed promptly.

Related Terms

1. Vascular Disorders of the Intestine: This broader category includes various conditions affecting blood flow to the intestines, including K55.02.
2. Acute Intestinal Ischemia: This term describes a sudden decrease in blood flow to the intestines, which can lead to infarction.
3. Bowel Infarction: A general term that can refer to infarction occurring in any part of the bowel, including the small intestine.
4. Intestinal Necrosis: This term describes the death of intestinal tissue due to lack of blood supply, which can be a consequence of acute infarction.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and coding conditions accurately. The terminology may vary based on clinical context, but they all relate to the underlying issue of compromised blood flow leading to tissue death in the small intestine.

In summary, K55.02 is associated with several alternative names and related terms that reflect the condition's nature and implications. Recognizing these terms can enhance communication among healthcare providers and improve patient care outcomes.

The diagnosis of acute infarction of the small intestine, represented by the ICD-10 code K55.02, involves a combination of clinical evaluation, imaging studies, and laboratory tests. Below are the key criteria and considerations used in diagnosing this condition.

Clinical Presentation

1. Symptoms: Patients typically present with acute abdominal pain, which may be severe and sudden in onset. Other common symptoms include nausea, vomiting, diarrhea, and signs of gastrointestinal bleeding. The pain may be localized or diffuse, depending on the extent of the infarction.

2. Physical Examination: A thorough physical examination may reveal tenderness in the abdominal area, distension, and signs of peritonitis. The presence of a palpable mass or abnormal bowel sounds may also be noted.

Diagnostic Imaging

1. CT Scan: A computed tomography (CT) scan of the abdomen is often the preferred imaging modality. It can reveal bowel wall thickening, mesenteric edema, and the presence of free air or fluid, which may indicate perforation or ischemia.

2. Ultrasound: Abdominal ultrasound can be useful, particularly in evaluating blood flow to the intestines. Doppler ultrasound may help assess mesenteric blood flow and identify any vascular occlusions.

3. X-rays: Plain abdominal X-rays may show signs of bowel obstruction or perforation, although they are less specific than CT scans.

Laboratory Tests

1. Blood Tests: Laboratory tests may include a complete blood count (CBC) to check for leukocytosis, which can indicate infection or inflammation. Electrolyte imbalances and elevated lactate levels may also be present, suggesting ischemia.

2. Stool Tests: In cases where gastrointestinal bleeding is suspected, stool tests may be performed to check for occult blood.

Differential Diagnosis

It is crucial to differentiate acute infarction of the small intestine from other conditions that may present similarly, such as:

• Bowel Obstruction: Caused by adhesions, hernias, or tumors.
• Mesenteric Ischemia: Due to vascular occlusion or low blood flow.
• Pancreatitis: Inflammation of the pancreas that can mimic abdominal pain.

Conclusion

The diagnosis of acute infarction of the small intestine (ICD-10 code K55.02) is multifaceted, relying on a combination of clinical symptoms, imaging studies, and laboratory findings. Prompt diagnosis is critical, as timely intervention can significantly affect patient outcomes. If you suspect this condition, it is essential to consult a healthcare professional for a comprehensive evaluation and management plan.

When addressing the standard treatment approaches for ICD-10 code K55.02, which refers to "Acute infarction of small intestine," it is essential to understand the underlying condition and the typical management strategies employed in clinical practice.

Understanding Acute Infarction of the Small Intestine

Acute infarction of the small intestine occurs when there is a sudden loss of blood supply to a portion of the small intestine, leading to tissue death. This condition can result from various factors, including embolism, thrombosis, or strangulation due to bowel obstruction. Symptoms often include severe abdominal pain, nausea, vomiting, and signs of peritonitis.

Standard Treatment Approaches

1. Immediate Medical Management

• Stabilization: The first step in managing acute intestinal infarction is stabilizing the patient. This includes monitoring vital signs, ensuring adequate oxygenation, and establishing intravenous (IV) access for fluid resuscitation and medication administration.
• Pain Management: Analgesics are administered to manage severe abdominal pain, which is a common symptom of this condition.

2. Diagnostic Evaluation

• Imaging Studies: Diagnostic imaging, such as CT scans or ultrasound, is crucial for confirming the diagnosis and assessing the extent of the infarction. These studies help identify the cause of the infarction, such as vascular occlusion or obstruction.
• Laboratory Tests: Blood tests, including complete blood count (CBC) and metabolic panels, are performed to evaluate the patient's overall health and detect any signs of infection or organ dysfunction.

3. Surgical Intervention

• Exploratory Laparotomy: If the diagnosis of acute infarction is confirmed, surgical intervention is often necessary. An exploratory laparotomy allows the surgeon to directly visualize the intestines and assess the extent of the infarction.
• Resection of Necrotic Tissue: In cases where a segment of the small intestine is found to be necrotic, surgical resection of the affected area is performed. This is critical to prevent further complications, such as sepsis or perforation.
• Restoration of Blood Flow: If the infarction is due to vascular occlusion, procedures to restore blood flow, such as bypass surgery or endovascular techniques, may be indicated.

4. Postoperative Care

• Monitoring: After surgery, patients require close monitoring in a postoperative setting to watch for complications such as infection, bleeding, or bowel obstruction.
• Nutritional Support: Patients may need nutritional support, often starting with IV fluids and gradually transitioning to enteral feeding as bowel function returns.

5. Long-term Management

• Follow-up Care: Regular follow-up appointments are essential to monitor recovery and manage any long-term complications that may arise from the infarction or surgical intervention.
• Addressing Underlying Conditions: Identifying and managing any underlying conditions that contributed to the infarction, such as vascular disease or coagulopathies, is crucial for preventing recurrence.

Conclusion

The management of acute infarction of the small intestine (ICD-10 code K55.02) involves a combination of immediate medical care, diagnostic evaluation, surgical intervention, and postoperative management. Timely recognition and treatment are vital to improving patient outcomes and minimizing complications. As with any medical condition, a multidisciplinary approach involving surgeons, gastroenterologists, and nutritionists is often beneficial for comprehensive care.