Publication details

BŘIŠNÍ KATASTROFA U EXTRÉMNĚ OBÉZNÍ PACIENTKY

Title in English Abdominal disaster in an extremely obese patient.
Authors

KVASNICOVÁ Laura BERKOVÁ Alena KAŠPAR Michal VYSTRČILOVÁ Tamara CHOVANEC Zdeněk VEVERKOVÁ Lenka PENKA Igor ČERVEŇÁK Vladimír MAZÚR Andrej

Year of publication 2023
Type Article in Periodical
Magazine / Source Referátový výběr dermatovenerologie
MU Faculty or unit

Faculty of Medicine

Citation
web http://referatovyvyber.cz/dermatovenerologie/images/flippingbook/RVD-6-2022/RVD-6-2022.pdf
Keywords obesity; abdominal catastrophe; sepsis; laparostoma; frozen abdomen
Description Abdominal disaster in an extremely obese patient. The correct diagnosis of acute abdomen in a morbidly obese patient is often complicated by the large amount of subcutaneous adipose tissue that hinders the abdominal examination. A young female patient with extreme obesity, with a BMI of 88 kg/m2 and no other significant comorbidities, presented with diffuse abdominal pain and marked elevation of inflammatory markers. A plain abdominal radiograph and ultrasonography were not conclusive for the extreme obesity. For the same reason it was impossible to perform a CT scan. The cause of the abdominal catastrophe was stercoral peritonitis due to the perforation of gangrenous colon and terminal ileum in a multilocular large ventral hernia. The patient underwent 16 surgical revisions and the postoperative period was complicated by a multiorgan failure. After 66 days of intensive care, she was transferred to a standard ward for recovery and rehabilitation. Abdominal catastrophe in the extremely obese patients, despite limited diagnostic possibilities, requires early surgical intervention and special perioperative and postoperative care. Despite all available therapies, it is associated with high mortality. The aim of this case report is to describe the case of an extremely obese patient with abdominal catastrophe and to discuss specific therapies for these high-risk patients
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