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Rare disease
CASE REPORT
Recurrent hospitalisations in a rare case of hemicorporectomy: a challenging case for medical management
  1. Ajit Thakur1,
  2. Brittney Elliott2,
  3. Rohan Naik1,
  4. Nabeel Khan1,
  5. Shayna McQuaid3,
  6. Camelia Arsene1
  1. 1Department of Internal Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State University School of Medicine, Detroit, Michigan, USA
  2. 2Faculty of Medicine, McGill University, Montreal, Quebec, Canada
  3. 3Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
  1. Correspondence to Dr Ajit Thakur, canindianast{at}gmail.com

Summary

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.

  • urinary tract infections
  • ulcer
  • bone and joint infections
  • plastic and reconstructive surgery

https://doi.org/10.1136/bcr-2017-222375

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    Footnotes

    • BE and RN contributed equally.

    • Contributors AT was involved in patient care, the conception, design, critical review and write-up of multiple sections of the case report. BE was involved in the design, write-up of the background and part of the discussion section, and critical review of multiple drafts of the case report. RN was involved in patient care, the conception, design, critical review and write-up of abstract/summary, part of the discussion section and take home messages of the case report. NK was involved in patient care, the background research through 22 years of patient admissions, acquiring patient photographs and critical review of the case report. SM was involved in the design of the paper, analysis of the 22-year case history, write-up of the case presentation section and critical review of the case report. CA was the research supervisor and involved in the conception, design, data analysis and critical review of all sections of the case report. All authors were involved in the final approval and were in agreement regarding the accuracy and integrity of the case report.

    • Competing interests None declared.

    • Patient consent Obtained.

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