Rhabdomyolysis in a Morbidly Obese Patient After Oral Cavity Free Flap Reconstruction

• DOI: 10.1007/s12070-018-1535-9
• Publication Date: 2018-11-15T02:08:51Z
• Authors: Helena Wichova; Rahul Subbarayan; Thomas Muelleman; Kiran Kakarala
• Keywords: Morbidly obese; Free flap reconstruction

Post-operative rhabdomyolysis is a rare but life-threatening condition. Less than ten cases have been described in the otolaryngic literature and, to our knowledge, no reports exist in the setting of oral reconstructive free tissue transfer. Case report presentation. We discuss the clinical course that lead to the diagnosis of rhabdomyolysis with special consideration to simultaneous microvascular anastomosis. Serial lab values were closely followed to prevent kidney injury while preventing flap congestion. Excessive fluid resuscitation in free flap reconstruction has been associated with increased post-operative complications and flap failure. We present a cautionary case to highlight the need for early diagnosis of rhabdomyolysis, a condition that may become more prevalent in the head and neck population as obesity, the main risk factor, continues to increase worldwide.