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Panniculus morbidus: obesity-related abdominal wall lymphoedema
  1. Michael G Fadel,
  2. Michail Chatzikonstantinou,
  3. Charlotte Gilchrist,
  4. Brian Andrews
  1. General Surgery and Vascular Surgery, Medway Maritime Hospital, Gillingham, UK
  1. Correspondence to Dr Michael G Fadel, michael.fadel{at}


A 52-year-old female patient presented with a massive abdominal wall swelling that adversely affected her lifestyle. Imaging revealed significant subcutaneous oedema and the presence of grossly distended veins. Subsequently, she underwent a ‘toilet’ panniculectomy and abdominoplasty. We describe the surgical technique used to retract the lymphoedematous tissue facilitating excisional surgery, and discuss the pathophysiology of this condition and the possible contribution of venous obstruction to the development of subcutaneous oedema.

  • General surgery
  • Plastic and reconstructive surgery
  • Obesity (public health)
  • Obesity (nutrition)

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  • Contributors MGF: data/image collection, interpretation of the data, discussing and analysing data, collecting patient’s feedback and consent, writing of the paper.

    MC: planning and discussing the paper, interpretation of the data.

    CG: reporting and designing the paper, interpretation of the data.

    BA: performed the panniculectomy and abdominoplasty, planning and editing the paper, interpretation of the data.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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