Fat Embolism After Surgery for Gynecomastia
DOI:
https://doi.org/10.17986/blm.2015210949Keywords:
gynecomastia, fat embolism, autopsyAbstract
Gynecomastia is a benign enlargement of the male breast, secondary to gland proliferation and is a common problem among the male population. Treatment is primarily surgical. The most common intra- and postoperative complication is bleeding, followed by seroma, infection, insufficient results, inverted nipple and nipple necrosis. The embolism is one of the non-specific complications. A 24-year-old male was presented to the Surgery Department with a diagnosis unilateral gynecomastia. The operation proceeded without complication and around 10 hours later, the patient complained of weakness in all four limbs, later nausea, and vomiting and after full cardiopulmonary resuscitation, the patient died. The main reason for the patient’s death was concluded to be a postoperative pulmonary thromboembolism and fat embolism was discovered. In addition, there was a papillary carcinoma of the thyroid, which was missed before. We reported that unilateral gynecomastia associated with papillary carcinoma of the thyroid detected rarely at autopsy and fat embolism after surgery for gynecomastia is a rare complication.
Key words: Gynecomastia, fat embolism, autopsy
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Steele SR, Martin MJ, Place RJ., Gynecomastia: complications of the subcutaneous mastectomy, Am Surg. 2002;68(2):210-3. DOI: https://doi.org/10.1177/000313480206800222
Arvind A, Khan MA, Srinivasan K, Roberts J. Gynaecomastia correction: A review of our experience, Indian J Plast Surg. 2014;47(1):56-60. DOI: https://doi.org/10.4103/0970-0358.129624
Lapid O, Klinkenbijl JH, Oomen MW, van Wingerden JJ, Gynaecomastia surgery in the Netherlands: what, why, who, where…., J Plast Reconstr Aesthet Surg. 2014;67(5):702-6. DOI: https://doi.org/10.1016/j.bjps.2014.01.040
John E. Skandalakis, Gene L. Colborn, Thomas A. Weidman, Roger S. Foster, Jr., Andrew N. Kingsnorth, Lee J. Skandalakis, Panajiotis N. Skandalakis, Petros S. Mirilas, Skandalakis’ Surgical Anatomy, Chapter 03
Lorraine C. Pelosof, MD, PhD and David E. Gerber, MD, Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment, Mayo Clin Proc. 2010; 85(9): 838–854. DOI: https://doi.org/10.4065/mcp.2010.0099
Spinazze S, Schrijvers D. Metabolic emergencies. Crit Rev Oncol Hematol. 2006;58:79-89. DOI: https://doi.org/10.1016/j.critrevonc.2005.04.004
Angelique F. Vitug, MD,Lisa A. Newman, MD, MPH, FACS*, Complications in Breast Surgery, Surg Clin N Am 87 (2007) 431–451, University of Michigan, Breast Care Center, 1500 East Medical Center Drive,, 3308 CGC, Ann Arbor, MI 48167, USA
Rickles FR, Edwards RL. Activation of blood coagulation in cancer: Trousseau's syndrome revisited.Blood. 1983;62:14–31. DOI: https://doi.org/10.1182/blood.V62.1.14.bloodjournal62114
Silverstein MD, Heit JA, Mohr DN, et al. Trends in the incidence of deep venous thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158:585–593. DOI: https://doi.org/10.1001/archinte.158.6.585
Heit JA, Silverstein MD, Mohr DN, et al. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med. 2000;160:809–815. DOI: https://doi.org/10.1001/archinte.160.6.809
Robert H. I. Andtbacka, MDCM, FRCSC, Gildy Babiera, MD, S Eva Singletary, MD, Kelly K. Hunt, MD, FACS, Funda Meric-Bernstam, MD, FACS, Barry W. Feig, MD, FACS, Frederick C. Ames, MD, FACS, Merrick I. Ross, MD, FACS,Yvette Dejesus, MSN, and Henry M. Kuerer, MD, PhD, FACS; Incidence and Prevention of Venous Thromboembolism in Patients Undergoing Breast Cancer Surgery and Treated According to Clinical Pathways, Ann Surg. 2006; 243(1): 96–101.
Ramzi DW, Leeper KV. DVT and pulmonary embolism: Part 1. Diagnosis. Am Fam Phys. 2004;69:12.
Hatef DA, Kenkel JM, Nguyen MQ, et al. Thromboembolic risk assessment and the efficacy of enoxaparin prophylaxis in excisional body contouring surgery. Plast Reconstr Surg. 2008;122:269–79. DOI: https://doi.org/10.1097/PRS.0b013e3181773d4a
Bennet A, Sie P, Caron P, et al. Plasma fibrinolytic activity in a group of hypogonadic men. Scand J Clin Lab Invest. 1987;1:23–7. DOI: https://doi.org/10.1080/00365518709168865
Kamijo Y, Soma K, Nagai T, Kurihara K, Ohwada T. Acute massive pulmonary thromboembolism associated with risperidone and conventional phenothiazines. Circ J. 2003;1:46–8. DOI: https://doi.org/10.1253/circj.67.46
Piggott JR, Yazdani A. Bilateral pulmonary emboli after bilateral mastectomy in a 15 year-old boy with hypogonadism: A case report. Can J Plast Surg. 2010;18(4):e50-2. DOI: https://doi.org/10.1177/229255031001800404
James L. Glazer, MD, and Daniel K. Onion, MD, MPH, Fat Embolism Syndrome in a Surgical Patient, BRIEF REPORTS, JABFP 2001 Vol. 14 No. 4 (310-313)
Von Bergmann E. Ein fall todlicher fettembolie. Berlklin Wochenscher 1873;10:385.
Zhou L, Mu J, Dong HM, Zhang J., Forensic analysis of death caused by fat embolism: A study of 20 autopsy cases, Fa Yi Xue Za Zhi. 2013;29(6):431-3.
George J, George R, Dixit R, Gupta RC, Gupta N., Fat embolism syndrome, Lung India. 2013;30(1):47-53. DOI: https://doi.org/10.4103/0970-2113.106133
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