Abdominal compartment syndrome following abdominoplasty: A case report and review

ABSTRACT

Abdominoplasty is among the most commonly performed aesthetic procedures in plastic surgery. Despite high complication rate, abdominal contouring procedures are expected to rise in popularity with the advent of bariatric surgery. Patients with a history of gastric bypass surgery have an elevated incidence of small bowel obstruction from internal herniation, which is associated with non-specific upper abdominal pain, nausea, and a decrease in appetite. Internal hernias, when subjected to elevated intra-abdominal pressures, have a high-risk of developing ischemic bowel. We present a case report of patient with previous laparoscopic Roux-en-y gastric bypass who developed acute ischemic bowel leading to abdominal compartment syndrome following abdominoplasty. To the best of our knowledge, this is the first reported case in the literature. We herein emphasise on the subtle symptoms and signs that warrant further investigations in prospective patients for an abdominal contouring procedure with a prior history of gastric bypass surgery.

KEY WORDS

Abdminoplasty - abdominal compartment syndrome - bariatric surgery

 

Conflicts of interest

None declared.

• REFERENCES

• 1 American Society of Plastic Surgeons. Available from: http://www.plasticsurgery.org/News-and-Resources/Statistics.html [Last accessed on Jul 2011, cited on Jul 2011]
• 2 Breiting LB, Lock-Andersen J, Matzen SH. Increased morbidity in patients undergoing abdominoplasty after laparoscopic gastric bypass. Dan Med Bull 2011; 58: A4251
• 3 Hensel JM, Lehman Jr JA, Tantri MP, Parker MG, Wagner DS, Topham NS. An outcomes analysis and satisfaction survey of 199 consecutive abdominoplasties. Ann Plast Surg 2001; 46: 357-63
• 4 Floros C, Davis PK. Complications and long-term results following abdominoplasty: A retrospective study. Br J Plast Surg 1991; 44: 190-4
• 5 Neaman KC, Hansen JE. Analysis of complications from abdominoplasty: A review of 206 cases at a university hospital. Ann Plast Surg 2007; 58: 292-8
• 6 Hafezi F, Nouhi AH. Abdominoplasty and seroma. Ann Plast Surg 2002; 48: 109-10
• 7 van Uchelen JH, Werker PM, Kon M. Complications of abdominoplasty in 86 patients. Plast Reconstr Surg 2001; 107: 1869-73
• 8 Chaouat M, Levan P, Lalanne B, Buisson T, Nicolau P, Mimoun M. Abdominal dermolipectomies: Early postoperative complications and long-term unfavorable results. Plast Reconstr Surg 2000; 106: 1614-8
• 9 Momeni A, Heier M, Bannasch H, Stark GB. Complications in abdominoplasty: A risk factor analysis. J Plast Reconstr Aesthet Surg 2009; 62: 1250-4
• 10 Graça Neto L, Araújo LR, Rudy MR, Auersvald LA, Graf R. Intraabdominal pressure in abdominoplasty patients. Aesthetic Plast Surg 2006; 30: 655-8
• 11 Huang GJ, Bajaj AK, Gupta S, Petersen F, Miles DA. Increased intraabdominal pressure in abdominoplasty: Delineation of risk factors. Plast Reconstr Surg 2007; 119: 1319-25
• 12 Shen GX, Gu B, Xie F, Lu K, Wang HY, Zheng DN. et al. Three case reports of abdominal compartment syndrome after full abdominoplasty. Zhonghua Zheng Xing Wai Ke Za Zhi 2007; 23: 226-8
• 13 Tice JA, Karliner L, Walsh J, Petersen AJ, Feldman MD. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med 2008; 121: 885-93
• 14 Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K. et al. Bariatric surgery: A systematic review and meta-analysis. JAMA 2004; 292: 1724-37
• 15 Agha-Mohammadi S, Hurwitz DJ. Nutritional deficiency of post-bariatric surgery body contouring patients: What every plastic surgeon should know. Plast Reconstr Surg 2008; 122: 604-13
• 16 Macgregor AM. Small bowel obstruction following gastric bypass. Obes Surg 1992; 2: 333-339
• 17 Champion JK, Williams M. Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2003; 13: 596-600
• 18 Garza Jr E, Kuhn J, Arnold D, Nicholson W, Reddy S, McCarty T. Internal hernias after laparoscopic Roux-en-Y gastric bypass. Am J Surg 2004; 188: 796-800
• 19 Hwang RF, Swartz DE, Felix EL. Causes of small bowel obstruction after laparoscopic gastric bypass. Surg Endosc 2004; 18: 1631-5
• 20 Higa KD, Ho T, Boone KB. Internal hernias after laparoscopic Roux-en-Y gastric bypass: Incidence, treatment and prevention. Obes Surg 2003; 13: 350-4
• 21 Wang CB, Hsieh CC, Chen CH, Lin YH, Lee CY, Tseng CJ. Strangulation of upper jejunum in subsequent pregnancy following gastric bypass surgery. Taiwan J Obstet Gynecol 2007; 46: 267-71
• 22 Moore KA, Ouyang DW, Whang EE. Maternal and fetal deaths after gastric bypass surgery for morbid obesity. N Engl J Med 2004; 351: 721-2
• 23 Kakarla N, Dailey C, Marino T, Shikora SA, Chelmow D. Pregnancy after gastric bypass surgery and internal hernia formation. Obstet Gynecol 2005; 105: 1195-8
• 24 Charles A, Domingo S, Goldfadden A, Fader J, Lampmann R, Mazzeo R. Small bowel ischemia after Roux-en-Y gastric bypass complicated by pregnancy: A case report. Am Surg 2005; 71: 231-4
• 25 Eckhauser A, Torquati A, Youssef Y, Kaiser JL, Richards WO. Internal hernia: Postoperative complication of roux-en-Y gastric bypass surgery. Am Surg 2006; 72: 581-4 discussion 584
• 26 Talisman R, Kaplan B, Haik J, Aronov S, Shraga A, Orenstein A. Measuring alterations in intra-abdominal pressure during abdominoplasty as a predictive value for possible postoperative complications. Aesthetic Plast Surg 2002; 26: 189-92
• 27 Sarkar S, Smith D, Scott MH. A rare complication of abdominoplasty after bariatric surgery. Ann Plast Surg 2010; 64: 7-8