Fibrodysplasia ossificans progressiva with two emergency laparotomies: A case report

Introduction: Fibrodysplasia ossificans progressiva (FOP) is a disorder causing progressive heterotopic ossification of muscles, tendons, and ligaments. Invasive procedures such as surgery should be avoided, because physical stimulation causes heterotopic ossification.

Presentation of case: A 40-year-old Japanese man with FOP was transported to our hospital with sudden abdominal pain. Emergency surgery was performed because a computed tomography scan showed the presence of intraabdominal free air. We diagnosed peritonitis due to perforation of Meckel's diverticulum and performed a small intestinal resection. The day after surgery, airway obstruction was recognized, and tracheostomy was required. Six months after surgery, a strangulated small bowel obstruction developed, and a second laparotomy was performed. As the patient continued to have difficulty swallowing, we constructed a gastrostomy at the time of the second surgery. He was discharged with no complications.

Discussion: Ossification of the abdominal incision wound due to surgical invasion was suspected, but it did not occur in the short term.

Conclusion: Two laparotomies could be performed safely in a patient with FOP.

Keywords: Case report; Fibrodysplasia ossificans progressiva; General surgery; Heterotopic ossification.