2019, Number 1
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Cir Plast 2019; 29 (1)
Visceral perforation during liposuction
Cuenca-Pardo J, Contreras-Bulnes L, Quinta-Vilchis C
Language: Spanish
References: 21
Page: 108-119
PDF size: 242.20 Kb.
ABSTRACT
The case reported is of a 43-year-old woman weighing 67 kg, with a history of several abdominal surgeries, including liposuction. On examination a globose abdomen, the presence of scars and adhesions, important adipose panicle and a sagging abdominal wall were found. A liposuction of the abdomen, trunk and extremities with straight cannulas of 3 mm x 35 cm in length was performed; access was through two incisions made in the pubic area. Surgeons infiltrated 4,000 mL of solution with vasoconstrictors and aspirated 3,000 mL. The surgeons did not notice the perforation. The patient was discharged 5 hours after surgery. Nine hours later, she ate at home and in doing so severe pain occurred in the abdomen. In the hours that followed abdominal distension was added, and difficulty in channeling gases, with deterioration of her general conditions. At 48 hours the discomfort became intolerable, she was treated by a general surgeon, had some laboratory tests and simple x-rays of the abdomen and chest were taken, finding sub-diaphragmatic free air. Exploratory laparotomy was performed, finding an abdominal wall perforation site 6 cm below the navel, evidence of peritonitis and a jejunum perforation. Resection of the affected segment and an anastomosis of the intestinal handles were carried out. The patient managed to survive with minimal functional sequelae. The perforation occurred in the area considered the most critical. The conditions of the periumbilical area, thin and long cannulas and a distant access are the factors related to perforation.
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