Fig. 4. 36-year-old woman who had received liposuction 2 days before presented with abdominal pain and shock.

Her blood pressure was 70 mm Hg systolic and 50 mm Hg diastolic. A. On non-contrast CT image, massive subcutaneous emphysema is seen (arrowheads). At abdominal wall incision, and staining from faecal material is seen at subcutaneous fat layer. B. During exploratory laparotomy, perforation site was detected at ileum. After resection of small bowel and massive peritoneal irrigation, retention suture was made at muscle layer. Subcutaneous fat layer and skin were not closed so that infected material could be effectively drained. C. On photograph taken during surgery, colour changes to rectus sheath are seen, which were likely attributable to inflammation (asterisk). In spite of immediate and intensive care, she died 4 days later.