Small Bowel Perforation Following Abdominal Suction-assisted Liposuction

Pneumothorax, Pneumomediastinum, and Pneumoperitoneum After Combined Abdominoplasty and Liposuction

“…The rate of pneumoperitoneum is likely even lower, with the literature limited to a few case reports and series. 2,[9][10][11][12][13] The presence of abdominal wall abnormalities, prior surgery, and liposuction being performed on the flanks, back, and axilla has been shown to be associated with the violation of the thoracic and abdominal cavities. 1,6 The current case highlights the importance of keeping a wide differential diagnosis when evaluating patients postoperatively.…”

“…Observation with serial abdominal examinations is appropriate in this scenario, with an extremely low threshold for exploration should the patient deteriorate clinically, as a missed hollow viscus or visceral injury has been shown to be rapidly fatal. [2][3][4][5][11][12][13] While liposuction remains a relatively safe procedure, clinicians should remain aware of the possible life-threatening complications which may present. Extensive preoperative evaluation (including extensive surgical history), physical examination, and adjunctive imaging modalities, such as ultrasound and CT scan, should be undertaken to prevent these events.…”

“…A study by Mentz et al 1 reported the rate of pneumothorax to be 0.04% after liposuction in a case series of over 16,000 patients. The rate of pneumoperitoneum is likely even lower, with the literature limited to a few case reports and series 2,9–13 . The presence of abdominal wall abnormalities, prior surgery, and liposuction being performed on the flanks, back, and axilla has been shown to be associated with the violation of the thoracic and abdominal cavities 1,6 …”

“…With regard to the pneumoperitoneum, the patient never developed any signs of peritonitis, so violation of the abdominal fascia without visceral injury was the likely diagnosis. Observation with serial abdominal examinations is appropriate in this scenario, with an extremely low threshold for exploration should the patient deteriorate clinically, as a missed hollow viscus or visceral injury has been shown to be rapidly fatal 2–5,11–13 …”