Bekeny Jenna C, Huffman Samuel S, Thomas Chris, Tumminello Mariana, Kata Anna, Parikh Rajiv, Tom Laura K, Kleiber Grant M
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road, Washington, NW, 20007, USA.
Georgetown University School of Medicine, Washington, DC, USA.
Aesthetic Plast Surg. 2024 Mar;48(5):946-952. doi: 10.1007/s00266-023-03567-w. Epub 2023 Aug 31.
As one of the most commonly performed cosmetic procedures, liposuction is relatively safe. Bowel injury following liposuction is a rare but devastating complication, which necessitates hospital admission and surgical intervention. The authors highlight a case report describing the presentation, diagnosis, and management of a patient with bowel injury following liposuction.
A 58-year-old woman presented with abdominal pain, erythema, and discharge three days after 360-degree abdominal liposuction with concomitant fat grafting to bilateral buttocks at an outpatient surgery center. Bowel perforation was suspected after CT-scan revealed extraluminal gas in the abdomen and communication that traversed the peritoneum. Exploratory laparotomy was performed which demonstrated at least one site of distinct perforation of the small bowel and an area omentum noted to be inflamed, thickened and with a purulent rind. The patient underwent 20-cm small bowel resection and partial omentectomy temporarily closed with negative pressure wound therapy. After subsequent abdominal wall debridements the patient received ventral hernia repair with bridging mesh and abdominal closure.
While safe, elective cosmetic procedures are not without risk of serious and even fatal complications. Providers must be familiar with the presentation of bowel injury following abdominal liposuction to prevent delays in appropriate surgical and medical care.
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作为最常见的美容手术之一，抽脂术相对安全。抽脂术后肠损伤是一种罕见但极具破坏性的并发症，需要住院治疗并进行手术干预。作者重点介绍了一例抽脂术后肠损伤患者的临床表现、诊断及治疗的病例报告。
一名58岁女性在门诊手术中心接受360度腹部抽脂并同期进行双侧臀部脂肪移植术后三天，出现腹痛、红斑及渗液。CT扫描显示腹腔内有肠外气体且有穿过腹膜的通道，怀疑有肠穿孔。遂进行剖腹探查术，发现小肠至少有一处明显穿孔，网膜区域有炎症、增厚且有脓性包壳。患者接受了20厘米小肠切除术和部分网膜切除术，并用负压伤口治疗暂时封闭。随后进行腹壁清创术后，患者接受了带桥接补片的腹疝修补术及腹壁缝合。
虽然择期美容手术是安全的，但并非没有严重甚至致命并发症的风险。医疗人员必须熟悉腹部抽脂术后肠损伤的表现，以避免在适当的手术和医疗护理上出现延误。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266。
