Cargando…

Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion

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 p...

Descripción completa

Detalles Bibliográficos
Autores principales: Inui, Keiko, Hanafusa, Takaaki, Namiki, Takeshi, Ueno, Makiko, Igawa, Ken, Yokozeki, Hiroo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869307/
https://www.ncbi.nlm.nih.gov/pubmed/27194978
http://dx.doi.org/10.1159/000445823
_version_ 1782432296046952448
author Inui, Keiko
Hanafusa, Takaaki
Namiki, Takeshi
Ueno, Makiko
Igawa, Ken
Yokozeki, Hiroo
author_facet Inui, Keiko
Hanafusa, Takaaki
Namiki, Takeshi
Ueno, Makiko
Igawa, Ken
Yokozeki, Hiroo
author_sort Inui, Keiko
collection PubMed
description 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, al-though 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.
format Online
Article
Text
id pubmed-4869307
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-48693072016-05-18 Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion Inui, Keiko Hanafusa, Takaaki Namiki, Takeshi Ueno, Makiko Igawa, Ken Yokozeki, Hiroo Case Rep Dermatol Published online: April, 2016 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, al-though 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. S. Karger AG 2016-04-21 /pmc/articles/PMC4869307/ /pubmed/27194978 http://dx.doi.org/10.1159/000445823 Text en Copyright © 2016 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Published online: April, 2016
Inui, Keiko
Hanafusa, Takaaki
Namiki, Takeshi
Ueno, Makiko
Igawa, Ken
Yokozeki, Hiroo
Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
title Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
title_full Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
title_fullStr Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
title_full_unstemmed Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
title_short Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion
title_sort intractable postoperative wounds caused by self-inflicted trauma in a patient with cutaneous munchausen syndrome presenting as a pyoderma gangrenosum-like lesion
topic Published online: April, 2016
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869307/
https://www.ncbi.nlm.nih.gov/pubmed/27194978
http://dx.doi.org/10.1159/000445823
work_keys_str_mv AT inuikeiko intractablepostoperativewoundscausedbyselfinflictedtraumainapatientwithcutaneousmunchausensyndromepresentingasapyodermagangrenosumlikelesion
AT hanafusatakaaki intractablepostoperativewoundscausedbyselfinflictedtraumainapatientwithcutaneousmunchausensyndromepresentingasapyodermagangrenosumlikelesion
AT namikitakeshi intractablepostoperativewoundscausedbyselfinflictedtraumainapatientwithcutaneousmunchausensyndromepresentingasapyodermagangrenosumlikelesion
AT uenomakiko intractablepostoperativewoundscausedbyselfinflictedtraumainapatientwithcutaneousmunchausensyndromepresentingasapyodermagangrenosumlikelesion
AT igawaken intractablepostoperativewoundscausedbyselfinflictedtraumainapatientwithcutaneousmunchausensyndromepresentingasapyodermagangrenosumlikelesion
AT yokozekihiroo intractablepostoperativewoundscausedbyselfinflictedtraumainapatientwithcutaneousmunchausensyndromepresentingasapyodermagangrenosumlikelesion