Fibrodysplasia ossificans progressiva with two emergency laparotomies: A case report. (2020)

• Record Type: Journal Article
• Authors: Okamoto, Nobuyuki; Tazaki, Tatsuya; Shintakuya, Ryuta; Hirano, Toshinori; Sasaki, Masaru; Takahashi, Shinya; Nakamitsu, Astushi
• Is Part Of: International journal of surgery case reports. Volume 73(2020)
• Page Start: 196
• Page End: 198
• Publication Date: 2020
• Subjects: Fibrodysplasia ossificans progressiva -- Heterotopic ossification -- General surgery -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.07.033
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: We underwent two emergency laparotomies for FOP patient. Ossification of the incision did not occur within 6 months. Two laparotomies could be performed safely in a patient with FOP. Abstract: Introduction: Fibrodysplasia ossificans progressiva (FOP) is a disorder causing progressive heterotopic ossification of muscles, tendons, and ligaments. Invasive procedures such as surgery should be avoided, because physical stimulation causes heterotopic ossification. Presentation of case: A 40-year-old Japanese man with FOP was transported to our hospital with sudden abdominal pain. Emergency surgery was performed because a computed tomography scan showed the presence of intraabdominal free air. We diagnosed peritonitis due to perforation of Meckel's diverticulum and performed a small intestinal resection. The day after surgery, airway obstruction was recognized, and tracheostomy was required. Six months after surgery, a strangulated small bowel obstruction developed, and a second laparotomy was performed. As the patient continued to have difficulty swallowing, we constructed a gastrostomy at the time of the second surgery. He was discharged with no complications. Discussion: Ossification of the abdominal incision wound due to surgical invasion was suspected, but it did not occur in the short term. Conclusion: Two laparotomies could be performed safely in a patient with FOP.