CPT® Code 44603

Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations

Suture repair of the small intestine, known as enterorrhaphy, is a surgical procedure aimed at addressing various conditions that lead to perforations in the small intestine. This procedure is specifically indicated for cases involving perforated ulcers, diverticula, wounds, injuries, or ruptures that result in multiple perforations within the intestinal wall. During the surgery, an incision is made in the abdomen to access the affected segment of the small intestine. The surgeon carefully removes this segment and places it on the operating table for further examination and repair. The intestinal contents are expressed from the segment to ensure a clear working area. To manage the perforation, the intestine is clamped both above and below the site of injury, allowing for controlled repair. Any bleeding that may occur is addressed through suture ligation of the involved blood vessels. The repair process involves meticulously closing the opening in the intestine by suturing the mucous membranes first, followed by the serous coat, and finally the muscular wall, ensuring a secure closure. After the repair is completed, the abdominal cavity is thoroughly cleansed using gauze and irrigation fluid as necessary to prevent infection. Additionally, drains may be placed if required, and the abdominal incision is then closed. It is important to note that CPT® Code 44602 should be reported for the suture of a single perforation, while CPT® Code 44603 is designated for cases where multiple perforations are repaired.