Chronic Expanding Hematoma Following Abdominoplasty

Abstract

Chronic expanding hematoma (CEH) is a relatively rare complication of trauma or surgery. We report a patient with CEH as a late complication of abdominoplasty. A 58-year-old woman underwent conventional abdominoplasty and thereafter refused to use a compression binder, citing discomfort. One month postoperatively, she presented with a gradually enlarging, painful abdominal mass. The results of ultrasonography and computed tomography were highly suspicious for CEH. The lesion was completely removed, together with surrounding fibrous tissue. Histopathology revealed a chronic hemorrhage collection with a fibrous capsule, consistent with CEH. This condition as a late complication of abdominoplasty has not previously been reported in the literature. However, an online medical consultation site features several abdominoplasty patients asking about persistent hematomas that sound suspicious for CEH. CEH might be underdiagnosed by surgeons. Although a postoperative binder may increase the risk of skin necrosis and deep vein thrombosis, appropriate compression treatment is necessary to prevent hematoma formation. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Plastic Surgery Complications: A Review for Emergency Clinicians

“…[66][67][68] Hematomas usually occur in the initial 24-hour postoperative period but have been reported months following the initial procedure. 61,69 Clinical presentation of hematomas depends on volume and rate of accumulation. Small hematomas are typically asymptomatic.…”

Chronic expanding hematoma mimicking seroma, following a totally extraperitoneal approach for inguinal hernia: a case report

“…Therefore, the incidence of this entity following herniorrhaphy is unclear, and symptoms are likely independent of size. Regardless of the CEH site, complete excision with removal of the capsule is reportedly necessary to prevent recurrence [ 3–5 ]. Postoperative seroma, which occasionally occurs following herniorrhaphy and has a similar appearance to CEH, should be clearly differentiated from CEH because, unlike CEHs, they often recede without surgical intervention.…”