Small Intestinal Perforation and Peritonitis After Liposuction

Mallappa, Mahesh; Rangaswamy, Mohan; Badiuddin, Mohamed Faruq

doi:10.1007/s00266-007-0050-2

Cited by 27 publications

(25 citation statements)

References 12 publications

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“…Without an index of suspicion, it may be rather late before a bowel perforation is diagnosed; the patient may present to a different facility or doctor with abdominal pain. [48] Bowel perforation is obviously due to a technical error or negligence. Factors that increase the risk are: Co-existing diagnosed or undiagnosed hernia, previous abdominal wall surgeries and visceral obesity with stretched muscles.…”

Section: Discussionmentioning

confidence: 99%

Minimising complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps

Rangaswamy

2013

Indian J Plast Surg

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Significant complications still occur after abdominoplasty, the rate varies widely in different series. This variation suggests that there is a lot of scope for improvement. This paper reviews the various complications and also the technical improvements reported in the last 20 years. The root cause of each complication is analysed and preventive steps are suggested based on the literature and the author's own personal series with very low complication rates. Proper case selection, risk stratified prophylaxis of thromboembolism, initial synchronous liposuction, flap elevation at the Scarpa fascia level, discontinuous incremental flap dissection, vascular preservation and obliteration of the sub-flap space by multiple sutures emerge as the strongest preventive factors. It is proposed that most of the complications of abdominoplasty are preventable and that it is possible to greatly enhance the aesthetic and safety profile of this surgery.

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Section: Discussionmentioning

confidence: 99%

Minimising complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps

Rangaswamy

2013

Indian J Plast Surg

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“…The patient typically presents with abdominal pain to the follow-up medical evaluation, where more analgesic, and in some cases, antibiotics are prescribed, with little or no improvement of the symptoms. It is interesting to note that because postoperative pain following liposuction is characterized by being mild and easy to control, it is repeatedly ignored by doctors during follow-up evaluations (6). Often, the pain persists and the patient is sent to the emergency department where they are typically evaluated by physicians who are not familiar with the complications of cosmetic surgery, raising the possibility that the diagnosis could be delayed even further.…”

Section: Discussionmentioning

confidence: 99%

Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting

Coronado-Malagón

Tauffer-Carrion

2012

Canadian Journal of Plastic Surgery

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A bdominal liposuction is one of the most frequently performed aesthetic surgeries, and it is considered to be a safe surgical procedure with a very low rate of complications. Bowel perforation is a well known but under-reported complication of abdominal liposuction, and is characterized by a difficult diagnosis and has the potential to be life threatening. Case presentationA 54-year-old woman, who was allergic to penicillin, with a history of lumbar spine surgery and peptic ulcer disease, presented to the emergency room 24 h after undergoing plastic surgery. Her primary complaints were moderate abdominal pain, characterized by a burning sensation in the epigastrium, nausea and malaise. The surgery was described as a three-stage surgery with bilateral breast augmentation and abdominal liposuction followed by facial fat grafting. The patient received general anesthesia for the procedure and was discharged the same day after being prescribed 30 mg of ketorolac tromethamine every 8 h, as needed for relief of pain. Her usual medications also included pantoprazole in the event of dyspepsia. The same day, she consulted a general practitioner by telephone complaining of dyspepsia, and she was prescribed 10 mL of magaldrate, butylhyoscine and metamizol every 8 h. One day after being discharged, she was transferred to the emergency room by ambulance because of persistent pain.On admission, she was dehydrated, her abdomen was tender, her peristaltic sounds were decreased in frequency and intensity, and there were no signs of peritoneal irriation. Her vital signs included a blood pressure of 110/70 mm/Hg, a pulse of 94 beats/min, a respiratory rate of 24 breaths/min and a temperature of 37.5°C. Laboratory tests showed leukocytosis of 12×10 9 /L with neutrophilia, a hemoglobin level of 120 g/L, a platelet level of 250×10 9 /L, and an electrolyte imbalance with a sodium level of 150 mmol/L, a potassium level of 3.2 mmol/L and a creatinine level of 114.92 µmol/L.She was admitted for observation with a presumptive diagnosis of dyspepsia and postoperative pain, and received 1 L of saline, 100 mg of tramadol and 40 mg of intravenous esomeprazole. Two hours later, her abdominal pain became more intense and was described as 'stabbing'; with no relief with the prescribed treatment, she underwent an abdominal computed tomography (CT) scan. Subdiaphragmatic free air was found on the CT scan (Figure 1), and an urgent exploratory laparotomy was performed. During surgery, 500 mL of free intestinal liquid, a small hematoma in the abdominal wall and a double punctiform 3 mm perforation of the jejunum (it was considered a single A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experie...

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“…El orden cronológico de las manifestaciones cuando se presentan estas complicaciones es: dolor abdominal persistente, distensión abdominal, abdomen rígido y dificultad para canalizar gases, con deterioro generalizado y sin tendencia a la mejoría clínica. [12][13][14][15][16][17][18][19][20][21] El daño y la sobrevida dependen del diagnóstico oportuno y del tratamiento adecuado. Las perforaciones del intestino delgado, si son tratadas antes del tercer día, pueden ser reparadas con cierre directo del asa intestinal afectada.…”

Section: Caso Clínicounclassified

Perforación visceral durante una liposucción

Cuenca-Pardo¹,

Contreras-Bulnes²,

Quinta-Vilchism³

2019

Cirugía Plástica

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V arios autores consideran que las perforaciones viscerales por cánulas de liposucción ocurren por la falta de experiencia del cirujano, además de las condiciones estructurales del paciente, tales como obesidad, abdomen globoso, presencia de hernias, eventraciones, cicatrices abdominales y adherencias fibrosas ocasionadas por liposucciones previas. 1-11 La zona de mayor riesgo durante una liposucción se localiza alrededor del ombligo, y la estructura que con más frecuencia se daña es el íleon. Los hallazgos cardinales en los casos de perforación de intestinos son dolor abdominal persistente y obstrucción dx.

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Small Intestinal Perforation and Peritonitis After Liposuction

Cited by 27 publications

References 12 publications

Minimising complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps

Minimising complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps

Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting

Perforación visceral durante una liposucción

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