Abstract

PORTES-CASTRO, Miguel-Alejandro et al. Pseudomembranous colitis after post-bariatric circumferential abdominoplasty. Case report. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.4, pp.369-375. ISSN 1989-2055.  https://dx.doi.org/10.4321/s0376-78922017000500006.

Patients undergoing reconstructive surgery of body contour after massive weight loss due to bariatric surgery, suffer important changes in the intestinal microbiota, its antimicrobial properties and the nutrient absorption capacity. These abnormalities, plus the utilization of prophylactic antibiotics for surgery and intestinal motility reducing agents, make patients vulnerable to nosocomial infections by opportunists such as Clostridium difficile, which has a clinical presentation that oscillates from mild to fulminant colitis.

We present a case of a patient with massive weight loss after a bypass surgery who underwent circumferential abdominoplasty in fleur de lis and presented pseudomembranous colitis in the postoperative period after self-administration of loperamide. Despite aggressive treatments, the patient required surgery with subtotal colectomy due to the development of toxic megacolon. Finally, she managed to overcome sepsis, however with gastrointestinal sequels that diminish quality of life.

It is extremely important to educate patients with massive weight loss about possible complications of reconstructive surgery and medications used, as well as their adherence to prescriptions made by the treating physician.

Keywords : Pseudomembranous colitis; Bariatric surgery; Abdominoplasty; Loperamide.

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