Intra-abdominal Deep Inferior Epigastric Vessel Course Does Not Preclude Successful DIEP Flap Breast Reconstruction.


Journal

Plastic and reconstructive surgery. Global open
ISSN: 2169-7574
Titre abrégé: Plast Reconstr Surg Glob Open
Pays: United States
ID NLM: 101622231

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 23 03 2020
accepted: 28 04 2020
entrez: 18 8 2020
pubmed: 18 8 2020
medline: 18 8 2020
Statut: epublish

Résumé

We present 2 patients in whom the course of the deep inferior epigastric vessels was intra-abdominal during deep inferior epigastric perforator (DIEP) flap breast reconstruction. Preoperative computed tomography angiography gave no indication of an unusual pedicle location. In both cases, pedicle dissection was completed safely without bowel injury, and reconstruction was completed successfully. Reconstructive surgeons need not abandon DIEP flap reconstruction upon discovering that the deep inferior epigastric vessels are intra-abdominal. Unfortunately, computed tomography angiography imaging does not identify this variant preoperatively. The risk of postoperative ileus after intra-abdominal pedicle dissection may be higher than the risk after dissection of retrorectus deep inferior epigastric pedicles, and thus it is reasonable to consider the use of prophylactic mesh in these cases.

Identifiants

pubmed: 32802645
doi: 10.1097/GOX.0000000000002934
pmc: PMC7413760
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e2934

Informations de copyright

Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

Références

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J Plast Reconstr Aesthet Surg. 2009 Sep;62(9):1112-7
pubmed: 18675605
J Reconstr Microsurg. 2014 Feb;30(2):121-5
pubmed: 24163223
J Surg Oncol. 2006 Nov 1;94(6):441-54
pubmed: 17061279

Auteurs

Douglas L Helm (DL)

Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Michael L Steigner (ML)

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Arman T Serebrakian (AT)

Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Jessica Erdmann-Sager (J)

Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Classifications MeSH