Beg Arshad, Qureshi Osama Ahmed, Siddiqui Faisal, Khurshaidi Nadeem
Department of General Surgery, Liaquat National Hospital, Karachi, Pakistan.
Liaquat National Hospital and Medical College, Karachi.
J Pak Med Assoc. 2020 Oct;70(10):1857-1859. doi: 10.47391/JPMA.647.
Necrotizing fasciitis are rare but often fatal conditions. A retroperitoneal origin is very rare and limited to case studies; very few cases have been reported in the literature. We report a case of 42-year-old man who presented with complaints of severe constipation and paraumbilical abdominal pain for the past three days. On examination, the abdomen was tender and distended, giving features of bowel obstruction. CT scan suggested perforated appendix. Subsequent exploration revealed retroperitoneal necrotizing fasciitis extending down to right testicular tissue. After extensive debridement and drain placement, the patient was admitted to the ICU where with intensive monitoring and aggressive daily dressing the patient survived. Necrotizing fasciitis of other anatomical sites are easier to diagnose as compared to retroperitoneal origin. Focus should be placed while dealing with cases of acute abdomen as early diagnosis and prompt surgical intervention is needed for successful treatment.
坏死性筋膜炎虽罕见但往往致命。腹膜后起源极为罕见,仅限于病例研究;文献中报道的病例极少。我们报告一例42岁男性,过去三天出现严重便秘和脐周腹痛。检查时,腹部压痛且膨隆,有肠梗阻表现。CT扫描提示阑尾穿孔。后续探查发现腹膜后坏死性筋膜炎向下延伸至右侧睾丸组织。在进行广泛清创和放置引流管后,患者被收入重症监护病房,经密切监测和每日积极换药,患者存活。与腹膜后起源的坏死性筋膜炎相比,其他解剖部位的坏死性筋膜炎更容易诊断。在处理急腹症病例时应予以关注,因为成功治疗需要早期诊断和及时的手术干预。