title: [Surgical reduction of fat surplus leading to pulmonary embolism].
abstract: Surgical reduction of fat surplus is usually performed on healthy individuals and is reported as a safe procedure as it is not associated with a lethal outcome. Due to the anticipation of peri- and postoperative bleeding as a result of the large wound area, which may have a negative influence on the cosmetic result, patients often receive no or only inadequate anticoagulation. We report three cases in which surgical reduction of fat surplus led to sudden collapse and cardiac arrest. In all of our patients, fatal pulmonary embolism was the cause of cardiac arrest. These patients received only inadequate or no anticoagulation. Early postoperative mobilization, elastic stockings and compressive wound-dressing did not prevent pulmonary embolism. In addition to early postoperative mobilization of the patient and even though there is a risk of perioperative bleeding complications, the use of anticoagulation is highly recommended in surgical procedures like abdominoplasty or dermolipectomy. If sudden dyspnea, chest pain, collapse or cardiac arrest occurs after surgical interventions like these, pulmonary embolism should be considered and further diagnostic steps should be initiated.
authors.affiliation: Universitätsklinik für Notfallmedizin, Universität Wien, Wien, Osterreich. nina.richling@meduniwien.ac.at
authors.forename: Nina
authors.initials: N
authors.lastname: Richling
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Friedrich
authors.forename: Maria
authors.initials: M
authors.lastname: Deutinger
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Riedmüller
authors.forename: Karin
authors.initials: K
authors.lastname: Janata
authors.forename: Anton N
authors.initials: AN
authors.lastname: Laggner
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001344:Autopsy; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D013902:Radiography, Thoracic; D013924:Thrombophlebitis / Q000150:complications; D036542:Tomography, Spiral Computed
chemical_list: D000925:Anticoagulants