Septisch-toxischer Schock nach Liposuktion

The mortality rate associated with liposuction has been estimated to amount to 20 per 100.000. The causes of death derived from case reports include pulmonary thromboembolism, fat embolism, pulmonary edema due to fluid overload, toxic side-effects of lidocaine, perforations of abdominal wall or viscera and infectious complications. The fatality of a 38-year-old healthy female is reported who died 5 days after tumescent liposuction with the clinical signs of septic shock. The autopsy and the histological examination showed the anatomical changes attributable to shock and a severe diffuse inflammation of the subcutaneous fatty tissue in the area of the puncture wounds but failed to disclose a preexisting infectious disease of the respiratory or urinary tract. The microbiological examination revealed enterococci in a blood specimen, Pseudomonas aeruginosa and enterococci in a specimen of the spleen and coagulase-negative staphylococci in a smear from the abdominal wall. The evidential value of the postmortem bacteriological findings and medicolegal aspects of informed consent in cosmetic surgery are discussed.