Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman.
10.15596/ARMS.2017.26.1.18
- Author:
Seong Hoon PARK
1
;
Joo Hyun KIM
;
In Suck SUH
;
Kwang Yong KIM
;
Hii Sun JEONG
Author Information
1. Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. hiisunj@gmail.com
- Publication Type:Case Report
- Keywords:
Disabled persons;
Constipation;
Aged;
Diabetes complications
- MeSH:
Abdominal Pain;
Aged*;
Colon, Sigmoid;
Colostomy;
Compliance;
Constipation;
Defecation;
Diabetes Complications;
Diagnosis;
Dietary Fiber;
Disabled Persons;
Early Ambulation;
Fecal Impaction;
Female;
Free Tissue Flaps*;
Hand;
Humans;
Immobilization*;
Lower Extremity;
Shock, Septic;
Thigh*;
Thumb*;
Walking;
Wounds and Injuries
- From:Archives of Reconstructive Microsurgery
2017;26(1):18-22
- CountryRepublic of Korea
- Language:English
-
Abstract:
Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.
