Massive Localized Abdominal Lymphedema Treatment Challenges

• Published in: Plastic and reconstructive surgery. Global open Vol. 8; no. 1; p. e2601
• Main Authors: Al-Tarrah, Khaled, Ashour, Tarek, Rao, Rajashankar, Rayatt, Sukhbir, Thomas, Sunil S
• Format: Journal Article
• Language: English
• Published: United States Copyright The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved 01.01.2020; Wolters Kluwer Health; Wolters Kluwer
• Subjects: Case Report
• ISSN: 2169-7574; 2169-7574
• DOI: 10.1097/GOX.0000000000002601

Massive localized lymphedema of the abdomen is a rare condition resulting from a neglected lower abdominal pannus associated with significant disability and morbidity. Compared to other surgical procedures, postbariatric surgery is usually considered a financial drain. In the United Kingdom, this requires National Health Service approval and delays may lead to sequelae that adversely impact on patients’ quality of life with increased morbidity. We present a wheelchair-bound patient whose body mass index increased from 53 to 82, while awaiting funding approval increasing her anesthetic and surgical risks. A multidisciplinary approach is mandatory for preoperative, intraoperative, and postoperative care for these patients including anesthetic input and high dependency unit care. Managing this patient was a significant anesthetic and surgical challenge with 47-kg resected tissue. The planning and perioperative measures to minimize morbidity are discussed.