Soin Sarthak, Rangan Sumathi Vijaya, Ali Faisal Shaukat, Okafor Chukwudumebi
Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA.
BMJ Case Rep. 2019 Mar 14;12(3):e228985. doi: 10.1136/bcr-2018-228985.
Necrotising fasciitis (NF) resulting from sigmoid perforation is rare, but none the less remains life threatening. Early surgical intervention and empiric broad-spectrum antibiotic remains the standard of care. A 65-year-old man with history of stage 4 rectal cancer presented with bilateral hip pain. An X-ray of the hip and pelvis to rule out fracture revealed abnormal gas pattern overlying the right hip. CT imaging revealed distal sigmoid perforation with air extending from the pelvis to posterior aspect of the right hip and thigh. Aggressive surgical intervention and antibiotic initiation was associated with successful outcomes in our patient. Although less common, sigmoid perforation leading to NF in posterior thigh is a reminder of a potentially lethal complication.
由乙状结肠穿孔引起的坏死性筋膜炎（NF）较为罕见，但仍然危及生命。早期手术干预和经验性广谱抗生素治疗仍是标准治疗方法。一名有4期直肠癌病史的65岁男性出现双侧髋部疼痛。为排除骨折而进行的髋部和骨盆X线检查显示右髋上方有异常气体影。CT成像显示乙状结肠远端穿孔，气体从骨盆延伸至右髋和大腿后侧。积极的手术干预和抗生素治疗使我们的患者获得了成功的治疗结果。虽然较少见，但乙状结肠穿孔导致大腿后侧发生NF提醒我们这是一种潜在的致命并发症。
