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Obesity Surgery

, Volume 19, Issue 11, pp 1599–1604 | Cite as

Pseudotumors after Primary Abdominal Lipectomy as a New Sequela in Patients with Abdominal Apron

  • Adrian DraguEmail author
  • Alexander D. Bach
  • Elias Polykandriotis
  • Ulrich Kneser
  • Raymund E. Horch
Research Article

Abstract

Background

Malnutrition and overweight is a common problem in modern societies. Primary abdominal lipectomy is a standard surgical tool in patients with these problems. However, unknown secondary problems result from recent advances in obesity surgery. Plication of the anterior musculoaponeurotic wall is a widely and commonly used operative technique during abdominoplasty. Many different plication techniques have been published. So far no common standard and long-term effectiveness is proven. In addition, there is no sufficient literature dealing with the postoperative risks of plication of the musculoaponeurotic wall.

Methods

Four patients with development of pseudotumors were reviewed. All four patients received 12 months in advance a primary abdominal lipectomy including a vertical plication of the musculoaponeurotic wall.

Results

All four patients were females with mean age of 61 years and mean body mass index (BMI) of 37 kg/m2. All four patients had developed a pseudotumor of the abdomen as a long-term complication more than 12 months after primary abdominal lipectomy including a vertical plication of the anterior rectus sheath.

Conclusion

One should be aware of the potential long-term risk of secondary postoperative hematoma formation, with or without partial necrosis of the anterior rectus sheath after vertical plication of the anterior musculoaponeurotic wall. Viewed clinically and radiologically, such sequelas may appear as pseudotumor like masses and require immediate revision.

Keywords

Abdominal wall Vertical plication Rectus sheath Abdominoplasty Force vector Body tension lines Pseudotumor 

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Adrian Dragu
    • 1
    Email author
  • Alexander D. Bach
    • 1
  • Elias Polykandriotis
    • 1
  • Ulrich Kneser
    • 1
  • Raymund E. Horch
    • 1
  1. 1.Department of Plastic and Hand Surgery, University ClinicUniversity of Erlangen-NürnbergErlangenGermany

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