Harada Shotaro, Kato Takaharu, Okada Shinichiro, Nakatani Kensuke, Matsumoto Risa, Nishida Kazuhiro, Komuro Hiroyasu, Yokoyama Ai, Takase Chikara, Suganuma Toshiyuki
Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa, 238-8567, Japan.
Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama 330-8503, Japan.
IDCases. 2017 Sep 9;10:112-114. doi: 10.1016/j.idcr.2017.09.002. eCollection 2017.
Necrotizing soft tissue infection (NSTI) is a rare but rapidly progressing soft-tissue infection. Few reports of NSTI caused by colon cancer have been published. We present a rare case of NSTI of the thigh associated the retroperitoneal spread of ascending colon cancer. A 64-year-old man had noticed right hip pain since 3 months before admission, he felt pain in the right thigh which was reddening, and he had difficulty in walking. He was referred to Yokosuka general hospital Uwamachi. Anterolateral aspect of his right thigh was reddening and swelling. The patient was diagnosed with a psoas abscess and a NSTI of the right thigh caused by penetration of ascending colon tumor. The patient underwent debridement of severely necrotized tissue in the right thigh, diverting ileostomy and subsequently a right hemicolectomy with reversal of the ileostomy were performed. He was discharged 70 days after the first surgery. Colon cancer can be a cause of retroperitoneal abscess accompanied by NSTI of the thigh. Two-stage surgery was an efficient option in this patient with NSTI of the thigh associated with locally advanced ascending colon cancer.
坏死性软组织感染(NSTI)是一种罕见但进展迅速的软组织感染。由结肠癌引起的NSTI报告很少。我们报告一例罕见的大腿NSTI病例,伴有升结肠癌的腹膜后扩散。一名64岁男性入院前3个月开始出现右髋部疼痛,随后感到右大腿疼痛且发红,行走困难。他被转诊至横须贺综合医院宇町分院。其右大腿前外侧发红肿胀。患者被诊断为腰大肌脓肿及因升结肠肿瘤穿透导致的右大腿NSTI。患者接受了右大腿严重坏死组织的清创术、回肠造口术,随后进行了右半结肠切除术并逆转回肠造口术。首次手术后70天出院。结肠癌可能是伴有大腿NSTI的腹膜后脓肿的病因。对于该伴有局部晚期升结肠癌的大腿NSTI患者,两阶段手术是一种有效的选择。