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经肛门脓肿引发广泛产气性软组织感染的保组织、根治性手术:病例报告。

Tissue-conserving, yet radical surgery for extensive gas-forming soft tissue infections arising from perirectal abscess: report of a case.

机构信息

Department of General Surgery, North Middlesex University Hospital National Health Service Trust, Sterling Way, London, United Kingdom.

出版信息

Surg Infect (Larchmt). 2012 Oct;13(5):332-5. doi: 10.1089/sur.2011.047. Epub 2012 Oct 5.

Abstract

BACKGROUND

Perirectal abscess is encountered commonly in surgical practice, and simple incision and drainage usually is sufficient. However, life-threatening sepsis may occur. In such instances, the high morbidity and mortality rates from the severe systemic inflammatory response syndrome (SIRS) associated with rapidly evolving necrotizing and gas-forming soft tissue infections are of major concern.

METHODS

Case report and review of pertinent literature.

RESULTS

A rare case of extensive necrotizing fasciitis of the torso arising from a perirectal abscess, in which the principles of radical surgical debridement were adhered to while minimizing disfigurement, is reported in a 19-year-old female. In some cases, despite the life-threatening nature of necrotizing fasciitis, it is possible to minimize tissue loss without compromising patient survival.

CONCLUSION

Planning of the patient's site rehabilitation for maximum cosmetic outcome commences at the time of surgical debridement and is especially important for the young patient.

摘要

背景

直肠周围脓肿在外科实践中很常见,通常只需简单的切开引流即可。然而,可能会发生危及生命的败血症。在这种情况下,与迅速发展的坏死和产气性软组织感染相关的严重全身性炎症反应综合征(SIRS)会导致很高的发病率和死亡率,这是主要关注点。

方法

病例报告和相关文献复习。

结果

报告了一例罕见的女性 19 岁患者,源自直肠周围脓肿的广泛坏死性筋膜炎,在遵循彻底外科清创原则的同时,最大限度地减少了畸形。在某些情况下,尽管坏死性筋膜炎具有危及生命的性质,但有可能在不影响患者生存的情况下最大限度地减少组织损失。

结论

在进行外科清创时就开始规划患者的部位康复,以获得最佳的美容效果,这对于年轻患者尤为重要。

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