Tatsuta Sayo, Morioka Daichi, Murakami Naoki, Ohkubo Fumio
Department of Plastic and Reconstructive Surgery, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8866, Japan.
Aesthetic Plast Surg. 2017 Feb;41(1):117-120. doi: 10.1007/s00266-016-0740-8. Epub 2016 Dec 29.
Chronic expanding hematoma (CEH) is a relatively rare complication of trauma or surgery. We report a patient with CEH as a late complication of abdominoplasty. A 58-year-old woman underwent conventional abdominoplasty and thereafter refused to use a compression binder, citing discomfort. One month postoperatively, she presented with a gradually enlarging, painful abdominal mass. The results of ultrasonography and computed tomography were highly suspicious for CEH. The lesion was completely removed, together with surrounding fibrous tissue. Histopathology revealed a chronic hemorrhage collection with a fibrous capsule, consistent with CEH. This condition as a late complication of abdominoplasty has not previously been reported in the literature. However, an online medical consultation site features several abdominoplasty patients asking about persistent hematomas that sound suspicious for CEH. CEH might be underdiagnosed by surgeons. Although a postoperative binder may increase the risk of skin necrosis and deep vein thrombosis, appropriate compression treatment is necessary to prevent hematoma formation. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
慢性扩展性血肿(CEH)是创伤或手术相对罕见的并发症。我们报告一例患者,其CEH为腹壁成形术的晚期并发症。一名58岁女性接受了传统腹壁成形术,术后因不适拒绝使用加压腹带。术后1个月,她出现逐渐增大的腹痛性腹部肿块。超声和计算机断层扫描结果高度怀疑为CEH。病变连同周围纤维组织被完全切除。组织病理学显示为有纤维包膜的慢性出血性血肿,符合CEH。这种情况作为腹壁成形术的晚期并发症此前在文献中未见报道。然而,一个在线医疗咨询网站上有几位腹壁成形术患者询问持续存在的血肿,听起来疑似CEH。CEH可能未被外科医生充分诊断。尽管术后使用腹带可能会增加皮肤坏死和深静脉血栓形成的风险,但适当的加压治疗对于预防血肿形成是必要的。证据级别V 本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266 。