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Perforation of viscera often under-reported, underestimated in liposuction

Visceral perforation during liposuction can be severe and, at times, fatal, but often goes unreported. However, using careful technique may help prevent the serious complication from occurring, according to researchers.

Nineteen visceral perforation cases, including 16 women and three men with a mean age of 50 years, were reviewed retrospectively. The procedures took place in France between July 2001 and January 2012.

Ten patients underwent abdominal liposuction only, whereas the other nine cases underwent abdominal liposuction along with abdominoplasty. The researchers observed a mean volume of abdominal liposuction of 1,365 mL, and all of the procedures were performed following adrenalized serum infiltration with or without lidocaine.

Abnormally intense pain and intestinal obstruction were common to all cases, according to the researchers. In one case, visceral perforation was noted during liposuction. Four cases were diagnosed on day 1, and 14 cases were diagnosed between days 2 and 7, according to the researchers. Surgeons used abdominal radiography to confirm diagnosis.

Treatment included emergency laparotomy, and digestive resection was carried out in 12 patients, with temporary stomy to the skin in 11 cases and end-to-end anastomosis in one case. The condition was fatal in three cases on days 2, 5 and 11.

The researchers found the liposuction cannula was responsible for perforations of the abdominal wall.

A thin abdominal wall, weakness or diastasis of the rectus abdominis muscle increase the risk of intra-abdominal perforation, according to the researchers. Abdominal distension also likely increases the risk.

The researchers emphasized the importance of follow-up immediately following the procedure, a few hours later and within 24 hours before discharge. – by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.