Eutrophication: spontaneous progressive dermatoliponecrosis. A Fatal Complication of Gross Morbid Obesity.
Spontaneous and progressive dermatoliponecrosis and panniculitis is an unusual complication of morbid obesity. A fatal case is reported, and the term eutrophication is suggested as an appropriately descriptive name for this intractable condition. A 45-year-old grossly morbidly obese female (weighing 286.4 kg) presented with spontaneous necrosis of skin and fat-folds of the abdomen, trunk, and thighs. She also had congestive cardiac failure, respiratory insufficiency and anemia. Congestive cardiac failure and anemia were treated aggressively. However, all attempts at control of the superficial tissue necrosis and the supervening infection failed. Superficial gangrene and putrefaction of the fat-folds progressed relentlessly, and death finally ensued due to sepsis and multiple system failure. The early signs of panniculitis, especially of grossly dependent fat and skin-folds in the morbidly obese must be recognized early and treated with aggressive weight loss, if this potentially fatal complication of morbid obesity is to be avoided.
Ramsey-Stewart
G
Department of Upper G.I. Surgery and T.P.N., Royal Prince Alfred Hospital, Sydney, Australia.