Diverticulitis Causing Failure of Deep Inferior Epigastric Flap Harvest in Breast Reconstruction

The deep inferior epigastric perforator flap is the gold standard in autologous tissue reconstruction after mastectomies. During the course of the dissection of the pedicle for this flap, one must peel the deep inferior epigastric artery off the peritoneum. In rare occasions, scarring from previous abdominal surgery can result in adherence of the deep inferior epigastric artery to the peritoneum. In this report, we describe a patient with adherence of the pedicle to the sigmoid colon due to diverticulitis in the absence of surgical history, which resulted in failure of flap harvest and long-term intestinal complications. Guidelines on imaging findings that may alert the surgeon to this rare situation are also discussed.