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吸脂术后多次肠穿孔致腹壁美学及功能重建。

Aesthetic and functional abdominal wall reconstruction after multiple bowel perforations secondary to liposuction.

机构信息

Department of Plastic and Reconstructive Surgery, Addenbrooke's University Hospital, Cambridge University Hospitals NHS Foundation Trust, UK.

出版信息

Aesthetic Plast Surg. 2011 Apr;35(2):274-7. doi: 10.1007/s00266-010-9591-x. Epub 2010 Nov 3.

DOI:10.1007/s00266-010-9591-x
PMID:21046103
Abstract

This report describes a case of aesthetic and functional abdominal wall reconstruction performed to salvage a deformed, scarred, and herniated anterior abdomen after severe peritonitis and partial rectus muscle necrosis secondary to multiple bowel perforations sustained during liposuction performed in a cosmetic clinic. The diagnosis of intestinal perforation was missed intraoperatively and in the immediate postoperative period. The patient was admitted 4 days after the surgery to the intensive therapy unit in septicemic shock. After resuscitation and stabilization, she was treated by debridement of the abdominal wall, bowel resection, and temporary jejunostomy and colostomy (reversed 10 months later). She was referred 18 months after liposuction to the Plastic Surgery Service with a large central midline abdominal incisional hernia presenting with thinned out skin (14 × 11 cm) overlying adherent bowel. A components separation technique was successfully used to reconstruct the abdominal wall, with no recurrent herniation 2 years later. Survivors of bowel perforations sustained during abdominal liposuction may later present with challenging aesthetic and functional problems, as described in this report. These long-term sequelae have not been addressed hitherto in the literature.

摘要

本报告描述了一例美容诊所行腹部抽脂术导致多发肠穿孔,术后发生严重腹膜炎和部分腹直肌坏死,遗留变形、瘢痕和疝的腹壁畸形,行腹壁整形和功能重建的病例。肠穿孔的诊断在术中及术后早期被漏诊。术后 4 天,患者因败血症性休克收入重症监护病房。复苏和稳定后,行腹壁清创、肠切除术和临时空肠造口及结肠造口术(10 个月后反转)。抽脂术后 18 个月,患者因中央中线大切口疝就诊,疝内容物为变薄的皮肤(14×11cm)覆盖粘连的肠管。成功使用了腹直肌分离技术重建腹壁,2 年后无复发疝。本报告描述了腹部抽脂术肠穿孔的幸存者可能会出现具有挑战性的美学和功能问题,这些长期后遗症迄今尚未在文献中报道。

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引用本文的文献

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Aesthetic Plast Surg. 2024 Mar;48(5):946-952. doi: 10.1007/s00266-023-03567-w. Epub 2023 Aug 31.
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Abdominal Visceral Injury, a Devastating Consequence of Abdominal Liposuction: A Case Report and Literature Review.腹部吸脂术的灾难性后果——腹部内脏损伤:一例报告及文献综述
Cureus. 2023 Jan 30;15(1):e34378. doi: 10.7759/cureus.34378. eCollection 2023 Jan.
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Bowel perforation after liposuction in abdominal contouring surgery: Case report.
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Int J Surg Case Rep. 2020;72:5-9. doi: 10.1016/j.ijscr.2020.05.012. Epub 2020 May 21.
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Aesthetic subunits of the trunk: Anatomy and behavior of skin and adipose tissue in each unit for better outcomes in liposuction.躯干的美学亚单位:各单位皮肤和脂肪组织的解剖结构及特性,以提高吸脂效果。
Indian J Plast Surg. 2018 May-Aug;51(2):115-122. doi: 10.4103/ijps.IJPS_117_18.
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