Deep inferior epigastric perforator (DIEP) flap

Case contributed by Chris O'Donnell , 11 Aug 2014
Diagnosis certain
Changed by Henry Knipe, 7 Jun 2019

Updates to Case Attributes

Title was changed:
DIEPDeep inferior epigastric perforator (DIEP) flap of the breast
Presentation was changed:
PHPast history of extensive DCIS in the left breast. Treated by subcutaneous mastectomy including the nipple and deep inferior epigastric perforator (DIEP) flap from the anterior abdominal wall.
Age changed from 50 to 50 years.
Body was changed:

A DIEP flap is a type of breast reconstruction whereby deep inferior epigastric perforators (DIEP) and connected fat (and/or skin) are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy without the sacrifice of any of the abdominal muscles.

The DIEP flap is similar to the TRAM flap but requires no muscle sacrifice. The perforators (ie(i.e. blood vessels) required to keep the overlying tissue alive in the DIEP flap lay just beneath or within the abdominal muscle and must be dissected out. A preliminary CT angiogram of the inferior epigastric arteries is required for surgical planning of this dissection.

  • -<p>A DIEP flap is a type of breast reconstruction whereby deep inferior epigastric perforators (DIEP) and connected fat (and/or skin) are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy without the sacrifice of any of the abdominal muscles.</p><p>The DIEP flap is similar to the TRAM flap but requires no muscle sacrifice. The perforators (ie blood vessels) required to keep the overlying tissue alive in the DIEP flap lay just beneath or within the abdominal muscle and must be dissected out. A preliminary CT angiogram of the inferior epigastric arteries is required for surgical planning of this dissection.</p>
  • +<p>A DIEP flap is a type of breast reconstruction whereby deep inferior epigastric perforators (DIEP) and connected fat (and/or skin) are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy without the sacrifice of any of the abdominal muscles.</p><p>The DIEP flap is similar to the TRAM flap but requires no muscle sacrifice. The perforators (i.e. blood vessels) required to keep the overlying tissue alive in the DIEP flap lay just beneath or within the abdominal muscle and must be dissected out. A preliminary CT angiogram of the inferior epigastric arteries is required for surgical planning of this dissection.</p>

Updates to Link Attributes

Title was removed:
DIEP flap of the breast
Type was removed.
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Updates to Link Attributes

Title was removed:
deep inferior epigastric perforator (DIEP) flap
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Updates to Primarylink Attributes

Updates to Study Attributes

Modality was set to MRI.
Caption was added:
Pre-operative scan
Findings was added:

The pre-operative MRI shows extensive abnormal enhancement throughout the left breast consistent with DCIS.

Images Changes:

Image MRI (3D MIP contrast) ( update )

Description was removed:
pre-operative MRI

Image MRI (3D MIP contrast) ( update )

Description was removed:
pre-operative MRI

Image 1 MRI (3D MIP contrast) ( update )

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Image 2 MRI (3D MIP contrast) ( update )

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Updates to Study Attributes

Findings was changed:

Left breast tissue replaced by fat with a rounded morphology. Note there is no nipple and the only enhancement is in veins in the overlying skin. The pre-operative MRI shows extensive abnormal enhancement throughout the left breast consistent with DCIS.

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