Abstract
Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications.
Highlights
Lymphedema refers to excessive lymphatic accumulation in the interstitial space and occurs as a result of inadequate drainage
We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain
We have presented three cases of presumed abdominal elephantiasis and reviewed the current literature on the subject
Summary
Lymphedema refers to excessive lymphatic accumulation in the interstitial space and occurs as a result of inadequate drainage. A 53-year-old, morbidly obese gentleman, with a weight of 725 pounds and BMI of 115, who had been homebound for the past 4 years, presented with worsening abdominal swelling and abdominal wall pain He noticed progressive increases in the thickness of the abdominal skin over the preceding 2 years. His past medical history was significant for type 2 diabetes mellitus, hypothyroidism, recurrent leg cellulitis, and obstructive sleep apnoea. A 80-year-old Caucasian female with morbid obesity (BMI of 55) was admitted with worsening shortness of breath and progressive abdominal and leg swelling Her past medical history was significant for congestive heart failure, hypertension, chronic kidney disease, and morbid obesity. There was only very minimal decrease in the leg swelling
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