Haematoma complicating subcutaneous fat necrosis of the newborn: a rare complication following therapeutic hypothermia
A term, large for gestational age male newborn, was admitted to the neonatal intensive care unit with meconium aspiration syndrome and severe hypoxic-ischaemic encephalopathy. The baby was treated with therapeutic hypothermia using a total body cooling blanket. After 48 hours, the baby developed ten...
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| Veröffentlicht in: | BMJ case reports 2020-06, Vol.13 (6), p.e234360 |
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| description | A term, large for gestational age male newborn, was admitted to the neonatal intensive care unit with meconium aspiration syndrome and severe hypoxic-ischaemic encephalopathy. The baby was treated with therapeutic hypothermia using a total body cooling blanket. After 48 hours, the baby developed tender, indurated subcutaneous nodules consistent with subcutaneous fat necrosis (SCFN). The lesions started initially over the back but gradually spread to cover both shoulders, upper arms, chest area and both thighs. On day 19 of life, multiple small nodules on the back softened and coalesced to form one sizeable fluctuant swelling over the thoracolumbar area. Over a few hours, the swelling rapidly progressed to a large, tense mass with sloughing of the gangrenous overlying skin. This unusual complication of SCFN required surgical intervention for evacuation and debridement of the haematoma followed by graft repair of the skin defect. |
| doi_str_mv | 10.1136/bcr-2020-234360 |
| format | Article |
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The baby was treated with therapeutic hypothermia using a total body cooling blanket. After 48 hours, the baby developed tender, indurated subcutaneous nodules consistent with subcutaneous fat necrosis (SCFN). The lesions started initially over the back but gradually spread to cover both shoulders, upper arms, chest area and both thighs. On day 19 of life, multiple small nodules on the back softened and coalesced to form one sizeable fluctuant swelling over the thoracolumbar area. Over a few hours, the swelling rapidly progressed to a large, tense mass with sloughing of the gangrenous overlying skin. This unusual complication of SCFN required surgical intervention for evacuation and debridement of the haematoma followed by graft repair of the skin defect.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2020-234360</identifier><identifier>PMID: 32532911</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Age ; Asymptomatic ; Babies ; Blood platelets ; Cardiac arrhythmia ; Case reports ; Cooling ; Debridement ; dermatology ; Diabetes ; Dissection - methods ; Fat Necrosis - complications ; Fat Necrosis - pathology ; Gangrene - etiology ; Gangrene - surgery ; Hematoma - etiology ; Hematoma - pathology ; Hematoma - surgery ; Humans ; Hypertension ; Hypotension ; Hypothermia ; Hypothermia, Induced - adverse effects ; Hypothermia, Induced - methods ; Hypoxia-Ischemia, Brain - complications ; Hypoxia-Ischemia, Brain - diagnosis ; Hypoxia-Ischemia, Brain - therapy ; Infant, Newborn ; Intensive care ; Male ; materno-fetal medicine ; Meconium Aspiration Syndrome - complications ; Meconium Aspiration Syndrome - diagnosis ; Meconium Aspiration Syndrome - therapy ; Necrosis ; Negative-Pressure Wound Therapy - methods ; Neonatal care ; neonatal health ; neonatal intensive care ; Newborn babies ; plastic and reconstructive surgery ; Plastic surgery ; Risk factors ; Skin & tissue grafts ; Skin Transplantation - methods ; Subcutaneous Fat - pathology ; Thrombocytopenia ; Treatment Outcome ; Unusual Presentation of More Common Disease/Injury ; Ventilators</subject><ispartof>BMJ case reports, 2020-06, Vol.13 (6), p.e234360</ispartof><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b492t-6f8f96a217065fe1b3d5c045ef3d8c26a5871da545a929de40fe929a302f3c43</citedby><cites>FETCH-LOGICAL-b492t-6f8f96a217065fe1b3d5c045ef3d8c26a5871da545a929de40fe929a302f3c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295416/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295416/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32532911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elsayed, Elhaytham Omar Sanad</creatorcontrib><creatorcontrib>Yusuf, Kamran</creatorcontrib><creatorcontrib>Fraulin, Frankie O G</creatorcontrib><creatorcontrib>Murthy, Prashanth</creatorcontrib><title>Haematoma complicating subcutaneous fat necrosis of the newborn: a rare complication following therapeutic hypothermia</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><addtitle>BMJ Case Rep</addtitle><description>A term, large for gestational age male newborn, was admitted to the neonatal intensive care unit with meconium aspiration syndrome and severe hypoxic-ischaemic encephalopathy. The baby was treated with therapeutic hypothermia using a total body cooling blanket. After 48 hours, the baby developed tender, indurated subcutaneous nodules consistent with subcutaneous fat necrosis (SCFN). The lesions started initially over the back but gradually spread to cover both shoulders, upper arms, chest area and both thighs. On day 19 of life, multiple small nodules on the back softened and coalesced to form one sizeable fluctuant swelling over the thoracolumbar area. Over a few hours, the swelling rapidly progressed to a large, tense mass with sloughing of the gangrenous overlying skin. This unusual complication of SCFN required surgical intervention for evacuation and debridement of the haematoma followed by graft repair of the skin defect.</description><subject>Age</subject><subject>Asymptomatic</subject><subject>Babies</subject><subject>Blood platelets</subject><subject>Cardiac arrhythmia</subject><subject>Case reports</subject><subject>Cooling</subject><subject>Debridement</subject><subject>dermatology</subject><subject>Diabetes</subject><subject>Dissection - methods</subject><subject>Fat Necrosis - complications</subject><subject>Fat Necrosis - pathology</subject><subject>Gangrene - etiology</subject><subject>Gangrene - surgery</subject><subject>Hematoma - etiology</subject><subject>Hematoma - pathology</subject><subject>Hematoma - surgery</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypotension</subject><subject>Hypothermia</subject><subject>Hypothermia, Induced - adverse effects</subject><subject>Hypothermia, Induced - methods</subject><subject>Hypoxia-Ischemia, Brain - complications</subject><subject>Hypoxia-Ischemia, Brain - diagnosis</subject><subject>Hypoxia-Ischemia, Brain - therapy</subject><subject>Infant, Newborn</subject><subject>Intensive care</subject><subject>Male</subject><subject>materno-fetal medicine</subject><subject>Meconium Aspiration Syndrome - complications</subject><subject>Meconium Aspiration Syndrome - diagnosis</subject><subject>Meconium Aspiration Syndrome - therapy</subject><subject>Necrosis</subject><subject>Negative-Pressure Wound Therapy - methods</subject><subject>Neonatal care</subject><subject>neonatal health</subject><subject>neonatal intensive care</subject><subject>Newborn babies</subject><subject>plastic and reconstructive surgery</subject><subject>Plastic surgery</subject><subject>Risk factors</subject><subject>Skin & tissue grafts</subject><subject>Skin Transplantation - methods</subject><subject>Subcutaneous Fat - pathology</subject><subject>Thrombocytopenia</subject><subject>Treatment Outcome</subject><subject>Unusual Presentation of More Common Disease/Injury</subject><subject>Ventilators</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1r3DAQhk1paUKac29F0EtpcaNP2-ohUELaBAK55NCbGMtSVottuZKckH8fGafbTaEQXTTDPPMyM29RvCf4KyGsOml1KCmmuKSMswq_Kg5JLeqylvjX6734oDiOcYvzY4Q3nL0tDhgVjEpCDou7CzADJD8A0n6YeqchufEWxbnVc4LR-DkiCwmNRgcfXUTeorQxOb9vfRi_IUABgtnr9iOyvu_9_aKT0QCTmZPTaPMw-SUfHLwr3ljoozl--o-Kmx_nN2cX5dX1z8uz71dlyyVNZWUbKyugpMaVsIa0rBMac2Es6xpNKxBNTToQXICksjMcW5MDYJhapjk7Kk5X2WluB9NpM6YAvZqCGyA8KA9OPa-MbqNu_Z2qqRScVFng05NA8L9nE5MaXNSm79fLKMoJlY2QDGf04z_o1s9hzNtlijFKq1rWmTpZqeWaMRi7G4ZgtbiqsqtqcVWtruaOD_s77Pg_Hmbg8wq0w_YFal_-wrsB_0c_AtHeuwE</recordid><startdate>20200611</startdate><enddate>20200611</enddate><creator>Elsayed, Elhaytham Omar Sanad</creator><creator>Yusuf, Kamran</creator><creator>Fraulin, Frankie O G</creator><creator>Murthy, Prashanth</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200611</creationdate><title>Haematoma complicating subcutaneous fat necrosis of the newborn: a rare complication following therapeutic hypothermia</title><author>Elsayed, Elhaytham Omar Sanad ; Yusuf, Kamran ; Fraulin, Frankie O G ; Murthy, Prashanth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b492t-6f8f96a217065fe1b3d5c045ef3d8c26a5871da545a929de40fe929a302f3c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Asymptomatic</topic><topic>Babies</topic><topic>Blood platelets</topic><topic>Cardiac arrhythmia</topic><topic>Case reports</topic><topic>Cooling</topic><topic>Debridement</topic><topic>dermatology</topic><topic>Diabetes</topic><topic>Dissection - methods</topic><topic>Fat Necrosis - complications</topic><topic>Fat Necrosis - pathology</topic><topic>Gangrene - etiology</topic><topic>Gangrene - surgery</topic><topic>Hematoma - etiology</topic><topic>Hematoma - pathology</topic><topic>Hematoma - surgery</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypotension</topic><topic>Hypothermia</topic><topic>Hypothermia, Induced - adverse effects</topic><topic>Hypothermia, Induced - methods</topic><topic>Hypoxia-Ischemia, Brain - complications</topic><topic>Hypoxia-Ischemia, Brain - diagnosis</topic><topic>Hypoxia-Ischemia, Brain - therapy</topic><topic>Infant, Newborn</topic><topic>Intensive care</topic><topic>Male</topic><topic>materno-fetal medicine</topic><topic>Meconium Aspiration Syndrome - complications</topic><topic>Meconium Aspiration Syndrome - diagnosis</topic><topic>Meconium Aspiration Syndrome - therapy</topic><topic>Necrosis</topic><topic>Negative-Pressure Wound Therapy - methods</topic><topic>Neonatal care</topic><topic>neonatal health</topic><topic>neonatal intensive care</topic><topic>Newborn babies</topic><topic>plastic and reconstructive surgery</topic><topic>Plastic surgery</topic><topic>Risk factors</topic><topic>Skin & tissue grafts</topic><topic>Skin Transplantation - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elsayed, Elhaytham Omar Sanad</au><au>Yusuf, Kamran</au><au>Fraulin, Frankie O G</au><au>Murthy, Prashanth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Haematoma complicating subcutaneous fat necrosis of the newborn: a rare complication following therapeutic hypothermia</atitle><jtitle>BMJ case reports</jtitle><stitle>BMJ Case Rep</stitle><addtitle>BMJ Case Rep</addtitle><date>2020-06-11</date><risdate>2020</risdate><volume>13</volume><issue>6</issue><spage>e234360</spage><pages>e234360-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>A term, large for gestational age male newborn, was admitted to the neonatal intensive care unit with meconium aspiration syndrome and severe hypoxic-ischaemic encephalopathy. The baby was treated with therapeutic hypothermia using a total body cooling blanket. After 48 hours, the baby developed tender, indurated subcutaneous nodules consistent with subcutaneous fat necrosis (SCFN). The lesions started initially over the back but gradually spread to cover both shoulders, upper arms, chest area and both thighs. On day 19 of life, multiple small nodules on the back softened and coalesced to form one sizeable fluctuant swelling over the thoracolumbar area. Over a few hours, the swelling rapidly progressed to a large, tense mass with sloughing of the gangrenous overlying skin. This unusual complication of SCFN required surgical intervention for evacuation and debridement of the haematoma followed by graft repair of the skin defect.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>32532911</pmid><doi>10.1136/bcr-2020-234360</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Age Asymptomatic Babies Blood platelets Cardiac arrhythmia Case reports Cooling Debridement dermatology Diabetes Dissection - methods Fat Necrosis - complications Fat Necrosis - pathology Gangrene - etiology Gangrene - surgery Hematoma - etiology Hematoma - pathology Hematoma - surgery Humans Hypertension Hypotension Hypothermia Hypothermia, Induced - adverse effects Hypothermia, Induced - methods Hypoxia-Ischemia, Brain - complications Hypoxia-Ischemia, Brain - diagnosis Hypoxia-Ischemia, Brain - therapy Infant, Newborn Intensive care Male materno-fetal medicine Meconium Aspiration Syndrome - complications Meconium Aspiration Syndrome - diagnosis Meconium Aspiration Syndrome - therapy Necrosis Negative-Pressure Wound Therapy - methods Neonatal care neonatal health neonatal intensive care Newborn babies plastic and reconstructive surgery Plastic surgery Risk factors Skin & tissue grafts Skin Transplantation - methods Subcutaneous Fat - pathology Thrombocytopenia Treatment Outcome Unusual Presentation of More Common Disease/Injury Ventilators |
| title | Haematoma complicating subcutaneous fat necrosis of the newborn: a rare complication following therapeutic hypothermia |
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