BLADDER PERFORATION AS A SEVERE COMPLICATION OF ABDOMINOPLASTY WITH LIPOSUCTION: A CASE REPORT

Abstract

Abdominoplasty combined with liposuction is a widely performed procedure in aesthetic plastic surgery and is generally considered safe when anatomical and technical principles are respected. However, rare but severe complications have been described, including visceral perforation, mainly associated with technical errors, inadequate control of surgical planes, and delayed postoperative recognition. We present the case of a patient who underwent abdominoplasty with liposuction and lipotransfer and subsequently developed a bladder laceration with hemoperitoneum, showing an insidious clinical course and progressive postoperative deterioration, ultimately leading to severe anemia, organ failure, and even cardiorespiratory arrest. Although the patient presented moderate risk factors, these did not justify the occurrence of a bladder injury in the context of an adequate technique, suggesting a poorly directed deep liposuction or blind dissection in the suprapubic region. The literature indicates that bladder perforation is an exceptional complication in this type of procedure and that its main impact on morbidity and mortality is related more to delayed diagnosis than to the initial injury itself. Intraoperative ultrasonography has been proposed as an effective tool to improve procedural safety by allowing precise identification of the surgical plane and prevention of injuries to deep structures. This case highlights the importance of appropriate patient selection, meticulous surgical technique, implementation of safety measures, and strict postoperative surveillance for the early detection of potentially lethal complications.

Keywords: Abdominoplasty; Liposuction; Urinary Bladder Injuries; Postoperative Complications; Case Reports. Source: MeSH