ࡱ> FHE'` vbjbjLULU 8..?.? zzz8,4B%h^|.$$$$$$$$$&h)$$$```$`$``V3#@# `;:z|s# E$|%0B%# ) )##j)#P`$$XB%D 6D6 Anatomic Location of Organs by Quadrant RIGHT UPPER QUADRANT (RUQ ) Liver Gallbladder Duodenum (Part 1, 2, 3) Head of pancreas Right kidney and adrenal Hepatic flexure of colon Omentum Part of ascending and transverse colon LEFT UPPER QUADRANT (LUQ) Stomach Jejunum Spleen Duodenum (Part 4) Left lobe of liver Body (or tail) of pancreas Left kidney and adrenal Splenic flexure of colon Part of transverse and descending colonRIGHT LOWER QUADRANT (RLQ) Ileocecal valve* Ileum* Cecum* Appendix Part of sigmoid colon* Right ovary and tube Right ureter Right spermatic cordLEFT LOWER QUADRANT (LLQ) Beginning of sigmoid colon* Part of descending colon* Sigmoid colon* Diverticula Rectum Left ovary and tube Left ureter Left spermatic cord  *small intestine per ASA considers upper abdomen from colon through the sigmoid colon. Comments indicate Use alternate (00840) when work is exclusively on sigmoid or rectum HERNIA TERMS From  HYPERLINK "http://hernia.tripod.com/index.html" \t "_blank" The NORTH PENN HERNIA INSTITUTE INCARCERATION The trapping of abdominal contents within the Hernia itself. The bulge cannot be reduced or pushed back. This could mean that intestine from within the abdomen is trapped in the hernia and the risk of injury to abdominal contents and intestine is increased. Surgical release and hernia repair are emergently necessary to avoid injury to the intestine. STRANGULATION Injury to the blood circulation to the intestine caused by  HYPERLINK "http://hernia.tripod.com/vocab2.html" \l "INC" \t "_blank" Incarceration. The Intestine will become gangrenous or die if not corrected early. This is an absolute emergency situation requiring immediate surgery. Mortality rates are high in patients not treated quickly with surgery. PERITONEUM The PERITONEUM is the thin, membranous outer lining of the abdominal cavity, it fully surrounds the intestines and abdominal organs. It lies between the muscles of the abdominal wall, and the intestines. In our Tension Free techniques, mesh is placed between the under surface of the muscles, and the peritoneum layer, and not inside the abdomen itself. Therefore, mesh is not in contact directly with intestine and there is no concern about adhesions or intestinal injury. The peritoneum, although thin, is fully protective. The mesh however is under the muscle layer where it is much more effective in hernia repair than if it was placed on top of the muscle. INCISIONAL HERNIA (Ventral Hernia ) Ventral or Incisional Hernias occur in the area of a prior abdominal incision. They develop as the result of a thinning, separation or tear in the muscle or tendon closure from prior surgery, often due to too much tension placed on the closure itself. These hernias may be small and asymptomatic at first, but eventually enlarge and become problematic causing possible  HYPERLINK "http://hernia.tripod.com/vocab.html" \l "INC" Incarceration or  HYPERLINK "http://hernia.tripod.com/vocab.html" \l "STRAN" Strangulation. Surgical repair is best performed early, when first diagnosed. Patients who are at or near ideal body weight are the ideal candidates for a Tension Free mesh repair.  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