Chelsea and Westminster Hospital, London, UK.
*These authors contributed equally to the manuscript.
Ann R Coll Surg Engl. 2021 Jan;103(1):e26-e28. doi: 10.1308/rcsann.2020.0198. Epub 2020 Sep 24.
Fat necrosis occurs more frequently in patients who have obesity and diabetes mellitus and is linked to worsening of diabetes. Little evidence is available about surgical complications that are related to inflammation and necrosis of adipose tissue. We report two cases of young women with diabetes who underwent bariatric surgery and had complications resulting from extensive inflammation and necrosis of adipose tissue. The first patient was diagnosed with omental infarction, which is a type of fat necrosis that is rarely associated with obesity and bariatric surgery. The second patient had an intraoperative finding of mesenteric panniculitis, which resulted in an intra-operative change in the choice of bariatric surgery to do a sleeve gastrectomy instead of a gastric bypass. Surgeons who perform surgery on bariatric patients must be aware of complications related to excessive amount of adipose tissue.
脂肪坏死更常发生于肥胖和糖尿病患者，且与糖尿病恶化相关。关于与脂肪组织炎症和坏死相关的手术并发症，目前相关证据有限。我们报告了两例年轻糖尿病女性患者，她们接受了减重手术，并发了广泛的脂肪组织炎症和坏死。第一例患者被诊断为网膜梗死，这是一种罕见的与肥胖和减重手术相关的脂肪坏死。第二例患者术中发现肠系膜脂膜炎，导致手术方式改变，由胃旁路术改为胃袖状切除术。为肥胖症患者施行手术的外科医生必须意识到与过量脂肪组织相关的并发症。
