ICD-10: N83.511

Torsion of right ovary and ovarian pedicle

Additional Information

Description

The ICD-10 code N83.511 specifically refers to the medical condition known as "Torsion of right ovary and ovarian pedicle." This condition is characterized by the twisting of the right ovary and its supporting structures, which can lead to compromised blood flow and potential necrosis of the ovarian tissue if not addressed promptly.

Clinical Description

Definition

Ovarian torsion occurs when the ovary rotates around the ligaments that hold it in place, often involving the ovarian pedicle, which contains blood vessels and nerves. This twisting can obstruct blood flow, leading to ischemia and, if untreated, can result in the death of ovarian tissue.

Symptoms

Patients with torsion of the right ovary may present with a variety of symptoms, including:
- Acute abdominal or pelvic pain: This is often sudden and severe, typically localized to the right side.
- Nausea and vomiting: These symptoms may accompany the pain due to the acute nature of the condition.
- Abdominal tenderness: Physical examination may reveal tenderness in the right lower quadrant.
- Changes in menstrual cycle: Some patients may experience alterations in their menstrual patterns.

Diagnosis

Diagnosis of ovarian torsion typically involves:
- Clinical evaluation: A thorough history and physical examination are crucial.
- Imaging studies: Ultrasound with Doppler flow studies is commonly used to assess blood flow to the ovary. A lack of venous and arterial flow can indicate torsion.
- CT scans: While not the first-line imaging, CT scans can be utilized to confirm the diagnosis in certain cases.

Treatment

The primary treatment for torsion of the right ovary is surgical intervention, which may include:
- Detorsion: Untwisting the ovary to restore blood flow.
- Oophorectomy: In cases where the ovary is necrotic or severely damaged, removal of the affected ovary may be necessary.
- Preventive measures: In some cases, the surgeon may perform a procedure to secure the ovary in place to prevent future torsion.

Coding and Billing

The ICD-10-CM code N83.511 is used for billing and coding purposes in healthcare settings. It is essential for healthcare providers to accurately document this condition to ensure proper reimbursement and to maintain comprehensive medical records.

  • N83.51: Torsion of ovary, unspecified side.
  • N83.519: Torsion of ovary, unspecified.

Conclusion

Torsion of the right ovary and ovarian pedicle is a critical condition that requires prompt diagnosis and treatment to prevent serious complications. Understanding the clinical presentation, diagnostic methods, and treatment options is essential for healthcare providers managing patients with this condition. Accurate coding with ICD-10 code N83.511 is vital for effective communication in clinical settings and for appropriate billing practices.

Clinical Information

The ICD-10 code N83.511 refers to the condition of torsion of the right ovary and ovarian pedicle. This medical emergency occurs when the ovary twists around the ligaments that hold it in place, potentially compromising its blood supply. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management.

Clinical Presentation

Signs and Symptoms

Patients with ovarian torsion typically present with a sudden onset of abdominal or pelvic pain. The pain is often unilateral, localized to the affected side, and may be described as sharp or cramp-like. Key symptoms include:

  • Acute Pelvic Pain: The most common symptom, often severe and sudden in onset.
  • Nausea and Vomiting: These symptoms may accompany the pain due to the body's response to acute abdominal distress.
  • Abdominal Tenderness: Physical examination may reveal tenderness in the lower abdomen, particularly on the right side.
  • Fever: In some cases, a low-grade fever may be present, indicating possible inflammation or infection.
  • Changes in Bowel Habits: Patients may experience constipation or changes in bowel movements due to pain or discomfort.

Physical Examination Findings

During a physical examination, healthcare providers may observe:

  • Rebound Tenderness: This may indicate peritoneal irritation.
  • Guarding: Involuntary muscle contractions may occur in response to pain.
  • Adnexal Tenderness: Tenderness upon palpation of the adnexa (the area adjacent to the uterus) may be noted.

Patient Characteristics

Demographics

Ovarian torsion can occur in women of any age but is most commonly seen in:

  • Reproductive Age Women: The majority of cases occur in women aged 20 to 40 years, often during the menstrual cycle when the ovaries are more vascular and enlarged.
  • Pregnant Women: Torsion can also occur during pregnancy, particularly in the first trimester.

Risk Factors

Several factors may increase the likelihood of developing ovarian torsion, including:

  • Ovarian Cysts or Masses: The presence of cysts or tumors can increase the risk of torsion due to the added weight and mobility of the ovary.
  • Previous Ovarian Surgery: Surgical history may alter the anatomy and increase the risk of torsion.
  • Hypermobile Ovaries: Some women may have anatomical variations that predispose them to torsion.
  • Hormonal Changes: Fluctuations in hormones during the menstrual cycle can lead to increased ovarian size and vascularity, heightening the risk.

Conclusion

Ovarian torsion, represented by ICD-10 code N83.511, is a critical condition that requires prompt recognition and intervention to prevent complications such as ovarian necrosis. The clinical presentation typically includes acute unilateral pelvic pain, nausea, and tenderness upon examination. Understanding the patient demographics and risk factors can aid healthcare providers in identifying at-risk individuals and facilitating timely diagnosis and treatment. If you suspect ovarian torsion, immediate medical evaluation is essential to ensure the best possible outcome for the patient.

Approximate Synonyms

The ICD-10 code N83.511 specifically refers to the condition known as "Torsion of right ovary and ovarian pedicle." This medical diagnosis can be associated with various alternative names and related terms that help in understanding the condition better. Below are some of the alternative names and related terms for this diagnosis:

Alternative Names

  1. Ovarian Torsion: A general term that refers to the twisting of the ovary, which can occur on either side.
  2. Right Ovarian Torsion: Specifically indicates that the torsion is occurring on the right ovary.
  3. Torsion of Right Ovary: A straightforward description of the condition, emphasizing the affected side.
  4. Right Ovarian Pedicle Torsion: Highlights the involvement of the ovarian pedicle, which includes the blood vessels and supporting structures.
  1. Acute Abdomen: A term often used in clinical settings to describe sudden abdominal pain, which can be a symptom of ovarian torsion.
  2. Pelvic Pain: A common symptom associated with ovarian torsion, indicating discomfort in the lower abdomen.
  3. Ischemia: Refers to the reduced blood flow to the ovary due to the torsion, which can lead to tissue damage if not treated promptly.
  4. Surgical Emergency: Ovarian torsion is considered a surgical emergency due to the risk of losing the ovary if not addressed quickly.
  5. Adnexal Torsion: A broader term that includes torsion of the ovary and its associated structures, such as the fallopian tube.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and treating patients with this condition. The urgency of addressing ovarian torsion is underscored by the potential for severe complications, including loss of the ovary, if not treated within a critical time frame.

In summary, the ICD-10 code N83.511 encompasses a specific medical condition with various alternative names and related terms that reflect its clinical significance and urgency. Recognizing these terms can aid in effective communication among healthcare providers and enhance patient care.

Diagnostic Criteria

The diagnosis of torsion of the right ovary and ovarian pedicle, classified under ICD-10 code N83.511, involves a combination of clinical evaluation, imaging studies, and specific diagnostic criteria. Below is a detailed overview of the criteria and considerations used in diagnosing this condition.

Clinical Presentation

Symptoms

Patients with ovarian torsion typically present with acute abdominal or pelvic pain. Key symptoms may include:

  • Sudden onset of unilateral pelvic pain: Often severe and may be associated with nausea and vomiting.
  • Abdominal tenderness: Localized tenderness in the lower abdomen, particularly on the affected side.
  • Changes in menstrual cycle: Some patients may report changes in their menstrual patterns, although this is not always present.

Physical Examination

During a physical examination, healthcare providers may look for:

  • Adnexal tenderness: Tenderness upon palpation of the adnexa (the area adjacent to the uterus, including the ovaries and fallopian tubes).
  • Abdominal rigidity: Signs of guarding or rigidity in the abdomen may indicate peritoneal irritation.

Diagnostic Imaging

Ultrasound

Transvaginal ultrasound is the primary imaging modality used to diagnose ovarian torsion. Key findings may include:

  • Enlarged, edematous ovary: The affected ovary may appear enlarged and swollen.
  • Absence of venous or arterial flow: Doppler ultrasound can help assess blood flow; the absence of venous flow is particularly indicative of torsion.
  • Free fluid: The presence of free fluid in the pelvis may suggest associated hemorrhage or inflammation.

CT Scan

In some cases, a CT scan of the abdomen and pelvis may be utilized, especially if the diagnosis is uncertain or if there are concerns about other potential causes of abdominal pain. Findings may include:

  • Enlarged ovary: Similar to ultrasound findings, an enlarged ovary may be noted.
  • Displacement of the ovary: The affected ovary may be displaced from its normal position.

Laboratory Tests

While laboratory tests are not definitive for diagnosing ovarian torsion, they can help rule out other conditions. Common tests may include:

  • Complete blood count (CBC): To check for signs of infection or inflammation.
  • Urinalysis: To rule out urinary tract infections or other renal issues.

Differential Diagnosis

It is crucial to differentiate ovarian torsion from other conditions that may present similarly, such as:

  • Ovarian cyst rupture
  • Ectopic pregnancy
  • Pelvic inflammatory disease (PID)
  • Appendicitis

Conclusion

The diagnosis of torsion of the right ovary and ovarian pedicle (ICD-10 code N83.511) relies on a combination of clinical symptoms, physical examination findings, and imaging studies, primarily ultrasound. Prompt diagnosis is critical, as timely intervention can prevent complications such as ovarian necrosis. If you suspect ovarian torsion, it is essential to seek immediate medical attention for appropriate evaluation and management.

Treatment Guidelines

When addressing the standard treatment approaches for the ICD-10 code N83.511, which refers to the torsion of the right ovary and ovarian pedicle, it is essential to understand the condition's nature, symptoms, and the typical management strategies employed in clinical practice.

Understanding Ovarian Torsion

Ovarian torsion occurs when an ovary twists around the ligaments that hold it in place, leading to a compromised blood supply. This condition is considered a surgical emergency due to the risk of ovarian necrosis if not treated promptly. Symptoms often include sudden onset of severe pelvic pain, nausea, vomiting, and sometimes fever. Physical examination may reveal unilateral adnexal tenderness and a palpable adnexal mass.

Standard Treatment Approaches

1. Immediate Surgical Intervention

The primary treatment for ovarian torsion is surgical intervention, which is typically performed as an emergency procedure. The two main surgical approaches are:

  • Laparoscopy: This minimally invasive technique is preferred due to its benefits, including reduced recovery time, less postoperative pain, and smaller incisions. During laparoscopy, the surgeon can untwist the ovary and assess its viability. If the ovary is viable, it may be secured in place to prevent future torsion (a procedure known as oophoropexy) [1].

  • Laparotomy: In cases where laparoscopy is not feasible or if there are complications (such as significant hemorrhage or extensive necrosis), a laparotomy may be performed. This involves a larger incision in the abdomen to access the ovaries directly [2].

2. Assessment of Ovarian Viability

During surgery, the surgeon will assess the viability of the affected ovary. If the ovary is found to be necrotic (non-viable), it may need to be removed (oophorectomy). If the ovary is viable, the goal is to restore blood flow and prevent recurrence [3].

3. Postoperative Care

Post-surgery, patients typically require monitoring for complications such as infection or bleeding. Pain management is also an essential aspect of postoperative care. Patients are usually advised to avoid strenuous activities for a period to allow for proper healing [4].

4. Follow-Up and Prevention

Follow-up appointments are crucial to monitor recovery and address any complications. In some cases, patients may be counseled on lifestyle modifications or hormonal treatments to reduce the risk of future torsion episodes, especially if they have a history of recurrent torsion [5].

Conclusion

In summary, the standard treatment for N83.511, or torsion of the right ovary and ovarian pedicle, primarily involves surgical intervention, typically via laparoscopy, to untwist the ovary and restore blood flow. The assessment of ovarian viability during surgery is critical, and postoperative care focuses on recovery and prevention of recurrence. Prompt diagnosis and treatment are essential to preserve ovarian function and prevent complications associated with this condition.

For further information or specific case management, consulting a healthcare professional specializing in gynecology is recommended.

Related Information

Description

Clinical Information

  • Acute unilateral pelvic pain
  • Nausea and vomiting symptoms accompany pain
  • Abdominal tenderness on lower abdomen side
  • Fever in some cases indicating inflammation or infection
  • Changes in bowel habits due to pain or discomfort
  • Rebound tenderness indicates peritoneal irritation
  • Guarding from involuntary muscle contractions
  • Adnexal tenderness upon palpation of adnexa
  • Most common in reproductive age women 20-40 years old
  • Pregnant women at increased risk particularly first trimester
  • Ovarian cysts or masses increase torsion risk
  • Previous ovarian surgery increases torsion risk
  • Hypermobile ovaries predispose to torsion
  • Hormonal changes heighten risk of torsion

Approximate Synonyms

  • Ovarian Torsion
  • Right Ovarian Torsion
  • Torsion of Right Ovary
  • Right Ovarian Pedicle Torsion
  • Acute Abdomen
  • Pelvic Pain
  • Ischemia
  • Surgical Emergency
  • Adnexal Torsion

Diagnostic Criteria

  • Sudden onset of unilateral pelvic pain
  • Abdominal tenderness on the affected side
  • Adnexal tenderness upon palpation
  • Absence of venous flow on Doppler ultrasound
  • Enlarged, edematous ovary on ultrasound or CT scan
  • Displacement of the ovary from its normal position

Treatment Guidelines

  • Immediate surgical intervention required
  • Laparoscopy preferred due to minimal invasiveness
  • Assess ovarian viability during surgery
  • Remove necrotic ovary (oophorectomy)
  • Restore blood flow and prevent recurrence
  • Monitor for postoperative complications
  • Prescribe pain management and rest

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It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.