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2019, Number 1

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Cir Plast 2019; 29 (1)

Case of death by liposculpture: Medical opinion

Cuenca-Pardo J

Language: Spanish
References: 56
Page: 120-146
PDF size: 384.19 Kb.


ABSTRACT

The alterations that occur prior to the sudden death of patients operated on liposuction are hypotension, bradycardia, oxygen desaturation and asystole. The causes are fatty embolism, anesthetic poisoning, and vagal reflex due to high epidural block and toxic heart disease due to cocaine use. In the last four years we have identified six cases in similar conditions; we present the expert opinion of one of them. A case of a 43-year-old woman addicted to cocaine with prior liposuction; body weight 65 kg and height 1.65 m. A liposuction of the abdomen, sides and back was performed, having used saline solution + 1 vial of adrenaline for vasoconstriction, 3,000 mL and 300 mL of fat infiltrate in each buttock was aspirated. A double epidural block with 3 doses of anesthetics was used. The third dose of anesthetics coincided with fatty infiltration. In this moment the patient presented hypotension, bradycardia and oxygen desaturation that in a few minutes evolved to asystole. She did not respond to resuscitation maneuvers. The forensic pathology study reported vacuoles compatible with fat and established fulminant massive fat embolism, the cause of death. There are several mortal nosological entities that can occur during a liposculpture, all have similar clinical manifestations. Severity depends on the way the patient responds and they are difficult to diagnose and treat. With the data obtained and the report of the forensic study, the cause of death cannot be determined categorically. Studies are needed to look for these pathologies to establish the true diagnosis.


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