Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
| Autor: | Makiko Ueno, Ken Igawa, Takeshi Namiki, Hiroo Yokozeki, Takaaki Hanafusa, Keiko Inui |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Munchausen syndrome medicine.medical_treatment Poison control Dermatology Surgical Wound Dehiscence 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Pyoderma gangrenosum Negative-pressure wound therapy Postoperative wounds lcsh:Dermatology Medicine medicine.diagnostic_test business.industry Emergency department lcsh:RL1-803 medicine.disease Surgery 030220 oncology & carcinogenesis Skin biopsy Skin grafting Published online: April 2016 business Self-inflicted trauma |
| Zdroj: | Case Reports in Dermatology, Vol 8, Iss 1, Pp 97-101 (2016) Case Reports in Dermatology |
| ISSN: | 1662-6567 |
| Popis: | A 50-year-old Japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis. She presented with a painful ulcer on her right lower abdomen. She also presented with multiple scars, skin grafts on the extremities, and a missing left lower leg, the causes for all of which were unexplained. The results of her blood test were normal, except for the hemoglobin level. Histology of the skin biopsy specimen from the ulcer did not show any specific findings. The previous surgeon who had performed the laparoscopic cholecystectomy revealed that surgical wound dehiscence had occurred during her admission. After a body restraint had been applied, the ulcer improved. Medical records indicated that she had been admitted to the department of plastic surgery at our hospital for skin grafting of a leg ulcer. During that admission, she refused to consult with the department of psychiatry, although the staff suspected mental disorders. Therefore, we diagnosed her with cutaneous Munchausen syndrome. After vacuum-assisted closure (VAC) therapy had been performed to prevent her from traumatizing the ulcer again, it rapidly became granulated and reepithelialized. Munchausen syndrome is characterized by feigning physical symptoms to seek attention. Patients self-inflict numerous lesions, keep getting admitted to different hospitals, and feign acute illness, usually spectacular diseases. VAC therapy may be effective for preventing patients with cutaneous Munchausen syndrome from traumatizing their wounds. |
| Databáze: | OpenAIRE |
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