The decision seemed inevitable for James Paxton. And a second opinion from Dr. Neal ElAttrache in Beverly Hills provided verification for the end of his 2021 season.

Tuesday morning from Camden Yards in Baltimore, Mariners manager Scott Servais announced in his video pregame session that Paxton will indeed have season-ending surgery on his left elbow.

“At this point, it looks like he’s headed toward a surgery and we will miss him the rest of the season,” he said. “I feel terrible for Pax having to deal with this one again. But if I know Pax, he will take the right attitude with it, go forward and try to make the best out of it, and come back hopefully stronger than ever.”

Servais didn’t provide much in the way of details on the specifics of the surgery, or even the exact injury, seeming to be intentionally vague about the situation.

“I don’t know,” he said. “It’s going to be left arm, left elbow surgery. I don’t have the particulars on it.”

A report from MLB Network last week said Paxton would undergo Tommy John surgery to replace a torn ulnar collateral ligament. Paxton did not immediately answer text messages to clarify the injury or the procedure.

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Paxton was placed on the 10-day injured list last Tuesday with what was labeled as a left forearm strain. He exited his 2021 debut after just 24 pitches.

A strained flexor tendon in his forearm/elbow area ended Paxton’s 2020 season in mid-August. He blamed the injury on compensating for a lack of leg strength brought on by back surgery in February. But during spring training, Paxton never exhibited any issues with his elbow or forearm until Tuesday night.

“Well, it’s kind of been a process through the recovery of my flexor strain from last year,” he said after the game. “Throwing this offseason, going to bullpens, getting into spring training games. And that process was all going well, I was going through the levels and kind of building it up. I came in tonight and I was pretty confident that I was going to be good, but it turned out that it just was a little bit too much for what my flexor was ready for, I guess.

Paxton had hoped that the injury wasn’t quite as severe as the flexor strain.

“With the flexor strain before, there was a lot more pain than there is right now,” he said. “I’m feeling pretty optimistic that this could be a pretty quick thing. Obviously, I don’t know much right now. We’re getting some imaging done. And we’ll know more in the coming days.”

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The Mariners did get some hopeful injury news with Kyle Lewis moving closer to a return to action. The reigning American League Rookie of the Year started the season on the 10-day injured list with a bruised kneecap but could be activated on the upcoming homestand that starts Friday.

“I think it’s very realistic to expect Kyle Lewis to be in our lineup at some point in the next homestand,” Servais said. “He was able to get four at-bats yesterday at an alternate site game. He’s moving in the right direction, he’s starting to get at-bats and get some timing down. He hasn’t really gone full-out, testing it in the outfield yet, but it feels fine with everything he’s done to this point, including swinging the bat, and it will continue to build upon that.”