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Objectives: Knowledge of perforation of one or several intra-peritoneal organs during a liposuction is essential owing to frequent delay in diagnosis and possible dramatic consequences.

Introduction: Perforation of one or several intra-peritoneal organs during a liposuction is an exceptional but underestimated complication. Cases were evaluated by experts and are presented in a retrospective analysis.

Materials / method: Nineteen cases were evaluated. Sixteen women and 3 men, from 24 to 72 years of age, were operated in France between July 2001 and January 2012. Abdominal liposuction (200-2400) was performed in combination or not with an abdominoplasty.

Results: Uncommon pain and an occlusive syndrome were present in all of the patients. The peritonitis was never frank, replaced frequently by infraclinic peritonitis with septic and/or hypovolemic shock. Diagnosis, performed by abdominal scan between days 1 and 7, revealed intraperitoneal gas or liquid. Perforation, unique or multiple, owing to the intra-peritoneal passage of the cannula, often in the umbilical region and promoted by the presence of a hernia, involved the following organs: ileon (14 cases), jejunum (2), spleen (2), transverse colon, caecum and sigmoid. Death occurred in 3 cases.

Conclusion: Visceral perforation during liposuction, a severe and sometimes fatal complication with late and difficult diagnosis is not often reported. Careful technique, particularly if an umbilical approach is used, should avoid this dramatic complication.

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