ICD-10: K55.04

Acute infarction of the large intestine, classified under ICD-10 code K55.04, is a serious condition that occurs when blood flow to a portion of the large intestine is obstructed, leading to tissue death. This condition can result from various factors, including embolism, thrombosis, or other vascular issues. The management of this condition typically involves a combination of medical and surgical approaches, depending on the severity and underlying cause of the infarction.

Diagnosis and Initial Assessment

Before treatment can begin, a thorough diagnosis is essential. This typically includes:

• Clinical Evaluation: Patients often present with abdominal pain, distension, and changes in bowel habits. A detailed medical history and physical examination are crucial.
• Imaging Studies: CT scans are commonly used to visualize the abdomen and assess the extent of the infarction, as well as to identify any underlying vascular issues or complications such as perforation or abscess formation[1].
• Laboratory Tests: Blood tests may reveal signs of infection, inflammation, or organ dysfunction, which can guide treatment decisions[1].

Standard Treatment Approaches

Medical Management

1. Fluid Resuscitation: Patients may require intravenous fluids to maintain hydration and support blood pressure, especially if they are experiencing significant fluid loss due to vomiting or diarrhea[1].

2. Antibiotics: Broad-spectrum antibiotics are often initiated to prevent or treat secondary infections, particularly if there is a risk of perforation or peritonitis[1].

3. Pain Management: Analgesics are administered to manage abdominal pain, which can be severe in cases of infarction[1].

Surgical Intervention

In many cases, surgical intervention is necessary, especially if there is evidence of significant bowel necrosis or complications. The surgical options include:

1. Resection: The most common surgical approach is resection of the necrotic segment of the bowel. This may involve removing the affected portion of the large intestine and, if necessary, performing an anastomosis (reconnection of the bowel ends) or creating a colostomy if the bowel cannot be reconnected immediately[1].

2. Embolectomy: If the infarction is due to an embolism, an embolectomy may be performed to remove the obstructing clot from the mesenteric vessels[1].

3. Bowel Restoration: In cases where a colostomy is performed, subsequent procedures may be planned to restore bowel continuity once the patient has stabilized[1].

Postoperative Care

Postoperative management is critical for recovery and may include:

• Monitoring for Complications: Patients are closely monitored for signs of infection, bleeding, or bowel obstruction.
• Nutritional Support: Nutritional needs are assessed, and enteral or parenteral nutrition may be provided as needed during recovery[1].
• Follow-Up Imaging: Follow-up imaging may be necessary to ensure that the bowel is healing properly and to monitor for any complications.

Conclusion

The treatment of acute infarction of the large intestine (ICD-10 code K55.04) is multifaceted, involving both medical and surgical strategies tailored to the individual patient's condition. Early diagnosis and intervention are crucial to improving outcomes and minimizing complications. Continuous monitoring and supportive care play vital roles in the recovery process. If you suspect this condition, it is essential to seek immediate medical attention to ensure timely and appropriate treatment.

Acute infarction of the large intestine, classified under ICD-10 code K55.04, is a serious medical condition that arises from the interruption of blood supply to the colon, leading to tissue death. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for timely diagnosis and management.

Clinical Presentation

Acute infarction of the large intestine typically presents with a sudden onset of abdominal pain, which may be severe and cramp-like. The pain is often localized to the lower abdomen, particularly in the left quadrant, where the sigmoid colon is located. Patients may also exhibit signs of systemic illness, such as fever and tachycardia, indicating a potential inflammatory response or sepsis due to bowel necrosis.

Signs and Symptoms

1. Abdominal Pain:
   - Sudden, severe abdominal pain is the hallmark symptom. The pain may be diffuse or localized, often worsening over time.

2. Nausea and Vomiting:
   - Patients may experience nausea and vomiting, which can be attributed to bowel obstruction or irritation.

3. Diarrhea or Constipation:
   - Changes in bowel habits are common. Some patients may present with diarrhea, while others may have constipation due to obstruction.

4. Abdominal Distension:
   - The abdomen may appear distended due to gas accumulation or fluid retention.

5. Fever:
   - A low-grade fever may be present, indicating an inflammatory process.

6. Signs of Shock:
   - In severe cases, patients may exhibit signs of shock, including hypotension, tachycardia, and altered mental status, which require immediate medical attention.

Patient Characteristics

Certain patient characteristics can predispose individuals to acute infarction of the large 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 diseases, such as atherosclerosis, are more susceptible to mesenteric ischemia.

• Coagulation Disorders:

• Conditions that affect blood clotting can increase the risk of vascular occlusion leading to infarction.

• Previous Abdominal Surgery:

• Surgical history, particularly involving the abdomen, can lead to adhesions that may compromise blood flow.

• Chronic Conditions:

• Patients with chronic conditions such as diabetes, hypertension, or heart disease may have an increased risk due to compromised vascular health.

Conclusion

Acute infarction of the large intestine is a critical condition that requires prompt recognition and intervention. The clinical presentation is characterized by severe abdominal pain, nausea, changes in bowel habits, and potential signs of systemic illness. Understanding the associated patient characteristics can aid healthcare providers in identifying at-risk individuals and implementing preventive measures. Early diagnosis and treatment are essential to improve outcomes and reduce the risk of complications associated with this condition.

The ICD-10 code K55.04 refers specifically to "Acute infarction of large intestine." This condition is characterized by the sudden loss of blood supply to a segment of the large intestine, leading to tissue death. Understanding alternative names and related terms can help in clinical documentation, coding, and communication among healthcare professionals.

Alternative Names for Acute Infarction of Large Intestine

1. Colonic Infarction: This term is often used interchangeably with acute infarction of the large intestine, emphasizing the involvement of the colon specifically.
2. Ischemic Colitis: While ischemic colitis generally refers to inflammation of the colon due to inadequate blood supply, it can also encompass cases of acute infarction, particularly when the blood supply is severely compromised.
3. Large Bowel Infarction: This term highlights the affected area, which is the large bowel, and is synonymous with acute infarction of the large intestine.
4. Mesenteric Ischemia: This broader term refers to reduced blood flow to the intestines, which can lead to infarction. It is often used in discussions about the underlying causes of acute infarction.

Related Terms

1. Acute Mesenteric Ischemia: This condition involves a sudden decrease in blood flow to the intestines, which can lead to infarction of the large intestine.
2. Bowel Necrosis: This term describes the death of bowel tissue, which can result from acute infarction.
3. Intestinal Infarction: A general term that can refer to infarction occurring in any part of the intestine, including the large intestine.
4. Colonic Ischemia: This term refers to reduced blood flow to the colon, which can lead to ischemic colitis or infarction.

Conclusion

Understanding the alternative names and related terms for ICD-10 code K55.04 is essential for accurate diagnosis, coding, and treatment of patients experiencing acute infarction of the large intestine. These terms facilitate clearer communication among healthcare providers and ensure that patients receive appropriate care based on their specific conditions.

The diagnosis of acute infarction of the large intestine, classified under ICD-10 code K55.04, involves a combination of clinical evaluation, imaging studies, and laboratory tests. Here’s a detailed overview of the criteria typically used for this diagnosis:

Clinical Presentation

1. Symptoms: Patients often present with acute abdominal pain, which may be localized or diffuse. Other common symptoms include:
   - Nausea and vomiting
   - Diarrhea or constipation
   - Rectal bleeding or bloody stools
   - Abdominal distension

2. History: A thorough medical history is essential, focusing on:
   - Previous gastrointestinal disorders
   - Vascular diseases (e.g., atherosclerosis, embolism)
   - Recent surgeries or interventions
   - Risk factors such as age, hypertension, diabetes, and smoking

Physical Examination

• Abdominal Examination: The physical exam may reveal tenderness, guarding, or rebound tenderness in the abdomen, indicating peritoneal irritation.
• Vital Signs: Monitoring for signs of shock, such as hypotension or tachycardia, is crucial, as these may indicate severe complications.

Diagnostic Imaging

1. CT Scan: A computed tomography (CT) scan of the abdomen is the gold standard for diagnosing acute infarction of the large intestine. It can reveal:
   - Areas of bowel wall thickening
   - Mesenteric vascular occlusion
   - Presence of free air or fluid, indicating perforation

2. Ultrasound: In some cases, abdominal ultrasound may be used, particularly in emergency settings, to assess for fluid collections or bowel abnormalities.

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

Laboratory Tests

• Blood Tests: Laboratory evaluations typically include:
• Complete blood count (CBC) to check for leukocytosis, which may indicate infection or inflammation.
• Electrolytes and renal function tests to assess for dehydration or metabolic derangements.
• Coagulation profile if vascular occlusion is suspected.

Differential Diagnosis

It is essential to differentiate acute infarction of the large intestine from other conditions that may present similarly, such as:
- Diverticulitis
- Colorectal cancer
- Inflammatory bowel disease (IBD)
- Gastroenteritis

Conclusion

The diagnosis of acute infarction of the large intestine (ICD-10 code K55.04) is multifaceted, requiring a combination of clinical assessment, imaging studies, and laboratory tests to confirm the condition and rule out other potential causes of the symptoms. Early diagnosis and intervention are critical to prevent complications such as bowel necrosis or perforation, which can lead to significant morbidity and mortality.

Acute infarction of the large intestine, classified under ICD-10 code K55.04, refers to a critical medical condition characterized by the sudden loss of blood supply to a segment of the large intestine, leading to tissue death (necrosis). This condition is a form of bowel ischemia and can result from various underlying causes, including arterial occlusion, venous thrombosis, or severe hypotension.

Clinical Presentation

Symptoms

Patients with acute infarction of the large intestine typically present with a range of symptoms, which may include:

• Abdominal Pain: Sudden onset of severe abdominal pain, often localized to the affected area.
• Nausea and Vomiting: Accompanying gastrointestinal distress may lead to nausea and vomiting.
• Diarrhea or Constipation: Changes in bowel habits, including diarrhea or constipation, may occur.
• Fever: A low-grade fever may be present due to inflammation or infection.
• Signs of Shock: In severe cases, patients may exhibit signs of shock, such as hypotension and tachycardia, due to significant blood loss or sepsis.

Risk Factors

Several risk factors can predispose individuals to acute infarction of the large intestine, including:

• Atherosclerosis: Narrowing of the arteries due to plaque buildup can reduce blood flow.
• Embolism: Blood clots that travel to the mesenteric arteries can obstruct blood flow.
• Hypercoagulable States: Conditions that increase blood clotting can lead to thrombosis.
• Cardiovascular Diseases: Pre-existing heart conditions can contribute to reduced blood flow.
• Age: Older adults are at higher risk due to vascular changes and comorbidities.

Diagnosis

Imaging Studies

Diagnosis typically involves imaging studies to assess blood flow and identify areas of infarction. Common modalities include:

• CT Scan: A CT scan of the abdomen can reveal signs of bowel ischemia, such as bowel wall thickening, pneumatosis intestinalis (gas within the bowel wall), and mesenteric vessel occlusion.
• Ultrasound: Doppler ultrasound may be used to evaluate blood flow in the mesenteric arteries.

Laboratory Tests

Laboratory tests may include:

• Complete Blood Count (CBC): To check for signs of infection or anemia.
• Electrolytes and Renal Function Tests: To assess the impact of the condition on overall health.

Treatment

Immediate Management

The management of acute infarction of the large intestine is often urgent and may involve:

• Surgical Intervention: In cases of significant necrosis, surgical resection of the affected bowel segment may be necessary.
• Supportive Care: This includes fluid resuscitation, electrolyte management, and pain control.

Long-term Management

Post-operative care and management of underlying conditions are crucial to prevent recurrence. This may involve:

• Lifestyle Modifications: Dietary changes and increased physical activity to improve vascular health.
• Medications: Anticoagulants or antiplatelet agents may be prescribed to manage clotting disorders.

Conclusion

Acute infarction of the large intestine (ICD-10 code K55.04) is a serious condition requiring prompt diagnosis and treatment to prevent complications such as bowel perforation and sepsis. Understanding the clinical presentation, risk factors, and management strategies is essential for healthcare providers to effectively address this life-threatening condition. Early recognition and intervention can significantly improve patient outcomes and reduce morbidity associated with bowel ischemia.