Small intestinal perforation and peritonitis after abdominal suction lipoplasty

Suction lipoplasty for abdominal contouring in nonoperated patients is considered a safe procedure with a low incidence of local and systemic complications. Suction lipoplasty combined with a full abdominoplasty is, however, still controversial with a higher rate of local complications. A 56-year-old woman with a history of four laparotomies and two abdominoplasties was hospitalized with abdominal pain and signs of peritonitis after an ambulatory suction lipoplasty. During laparotomy for peritonitis the abdominal wall was found to be stiff and fibrotic, with massive adhesions to the intestine. Two small intestinal perforations caused soiling into the peritoneum. The perforated intestinal segment was resected and the postoperative history was uneventful. Both recent and former laparotomies in the lower abdomen represent a possible risk when suction lipoplasty is performed. An ultrasonographic or computed tomographic scan of the abdominal wall would identify or rule out any underlying fascial defect or hernia.