Recurrent hospitalisations in a rare case of hemicorporectomy: a challenging case for medical management. (4th January 2018)

• Record Type: Journal Article
• Authors: Thakur, Ajit; Elliott, Brittney; Naik, Rohan; Khan, Nabeel; McQuaid, Shayna; Arsene, Camelia
• Is Part Of: BMJ case reports. Volume 2018
• Publication Date: 2018-01-04
• Subjects: urinary tract infections -- ulcer -- bone and joint infections -- plastic and reconstructive surgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2017-222375
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements. In light of his diminished quality of life and poor prognosis, the patient's family chose to manage his condition conservatively with home hospice. This case illustrates the significant challenges in the medical and surgical management of hemicorporectomy patients.