CAISS - Abdomen
How many segments in the left lobe of the liver?
2 segments
How many segments in the right lobe of the liver?
6 segments
What is considered a "Major" skin laceration in the abdomen?
>20 cm and into the subcutaneous tissue
Define "Perforation" of an organ?
A full thickness laceration, but not complete transection
Define "No Perforation" of an organ?
A partial thickness laceration, such as a serosal tear. IE. Outerlayer
Describe an intraperitoneal bladder rupture.
A rupture within the peritoneuem.
Can fetal demise be coded as an injury?
No. It is a result of an abdominal injury not the injury itself.
Is the hip & pelvic bones structure part of the Abdominal region?
No. They are part of the extremity.
What is the serous membrane of an organ?
Peritoneum
Where is the gallbladder located?
under the liver
What are the "Other Named Veins?"
Portal, Renal, Splenic, Superior Mesenteric
What are the "Other Named Arteries?"
Renal, Hepatic and Splenic
What does ISS define as part of the abdominal region?
Skin(lower torso), Digestive, Abdominal & Pelvic Vessels, Lumbar Spine(vertebrae & cord)
When can a vessel injury be coded?
(1)If they are isolated injuries or (2)they are not included in an organ injury description
When can a retroperitoneum hemorrhage be coded?
Abdominal bleeding into the retroperitoneal space not associated to another organ, vessel or structure.
What terms can be used for "massive" organ lacerations?
Avulsion, Complex, Rupture, Tissue Loss, Deep
Synonyms for massive organ laceration.
Avulsion, complex, rupture, tissue loss, deep
When coding an organ which takes priority; OIS or clinical description?
Clinical Description
Patient sustains an injury to the hepatic duct between the gallbladder and liver. How would you code?
Code the injury once to the liver or the gallbladder, not both.
How are duct injuries coded between shared organs?
Code to a single organ not both.
If an injury occurs at the junction between the duodenum and the jejunum how is it coded?
Code to the jejunum
When can a retroperitoneal hemorrhage be coded?
Code when determined it is unrelated to another injury. IE unrelated to pancreas, duodenum, kidney, aorta, vena cava, mesenteric vessel and pelvic/vertebral fractures
How is a serosal tear coded?
Coded as a partial thickness injury
When a bilateral laceration of the Iliac artery is coded, what portion of the Iliac would this be in?
Common Iliac
What regions are included when coding a Iliac Artery injury?
Common, Internal and External
Define "Transection" of an organ?
Complete separation of two parts of an organ.
Describe the structure of the Duodenum.
D1 connects at the stomach, flowing into a descending curve at D2 which is the largest section, D3 is the transverse portion, D4 connects to the duodenum/jejunum fissure.
Coding a serosal tear.
Defined as a partial thickness laceration and coded as No Perforation
Can a Contusion & a laceration be coded to a single organ?
Depends. If the contusion is related to a laceration, No. If they are unrelated then Yes.
In the Duodenum what impacts the severity?
Disruption is dependent on location within the duodenum.
Which organs does "duct involvement" apply to?
Gallbladder, Liver and Pancreas
What is hemoperitoneum?
Intraperitoneal bleeding
How is Abdominal Compartment Syndrome coded?
It is not. It is a consequence of an injury.
What are the trabecular vessels?
It is the branches of the splenic artery within the spleen.
Define "Avulsion" of an organ?
It is when the an organ is repped / forcible tearing away from it's vascular system.
Define Skin Avulsion
It is when the top layer of skin is torn away.
What is a hilar disruption of the spleen?
It is when there is injury to the vascular attachment directly to the spleen.
Where is the spleen located?
LUQ behind the ribs adjacent to the stomach/pancreas.
What is subcutaneous tissue?
The layer of the skin directly below the dermis and superficial to muscle.
How is a hemoperitoenum coded
This injury is not coded. It is a sequela.
Define Perforation
This is a full thickness laceration but not a full transection
Define Transection
This is the complete separation of two parts of a structure
What are the Name Veins in the Abdomen?
Vena Cava, Common Iliac, Internal Iliac, External Iliac
When do you code a rupture?
When a more detailed code is not available
What is an extraperitoneal bladder rupture?
When the rupture is not within the peritoneum. Pushes the small intestine aside.
When do you utilize OIS grading?
When there is no relevant detailed descriptive clinical information available.
Where is the retroperitoneal space?
it is posterior to the peritoneum
What is the peritoneum?
the mucus membrane covering the abdominal cavity