Tarekegn Negassa Getachew, Moges Tadesse Girma, Guluju Feyera Abetu
Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Ethiopia.
Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Ethiopia.
Int J Surg Case Rep. 2024 Mar;116:109412. doi: 10.1016/j.ijscr.2024.109412. Epub 2024 Feb 20.
Necrotizing fasciitis (NF) is a rare and rapidly progressing soft tissue infection. The commonly involved body parts are the extremities and trunk. Necrotizing fasciitis (NF) involving the retroperitoneum is very uncommon but associated with higher morbidity and mortality. There are only a few patients survived according to the report.
This is a 19-year-old male patient presented with abdominal pain, high-grade fever, vomiting and abdominal distension for 3 days. On physical examination, he was hypotensive, tachycardic and febrile. He had a distended, tender abdomen, and hypoactive bowel sound. There were no significant pertinent findings on the other systems. Laboratory tests showed leukocytosis, thrombocytopenia, and elevated liver enzymes. After optimizing with resuscitation and initiating antibiotics, a laparotomy was performed. The finding was 300 ml of hemorrhagic fluid, ischemic cecum and ascending colon, and retroperitoneal necrosis. Subsequently, multiple debridement and right hemicolectomy with stoma was performed. Despite the close monitoring in the ICU, the patient died of uncontrolled sepsis.
Necrotizing fasciitis (NF) is a rapidly progressing infectious condition that requires urgent intervention. While it is rare for the retroperitoneum to be affected by NF, it is associated with a high mortality rate. The symptoms of retroperitoneal NF are not specific, making it difficult to diagnose. Here, we present a case of retroperitoneal NF with signs and symptoms of generalized peritonitis, resembling perforated appendicitis.
When patients are presented with a case of generalized peritonitis, it is important to include retroperitoneal NF as a potential differential diagnosis.
坏死性筋膜炎（NF）是一种罕见且进展迅速的软组织感染。常见受累身体部位为四肢和躯干。累及腹膜后的坏死性筋膜炎（NF）非常少见，但发病率和死亡率较高。据报道仅有少数患者存活。
这是一名19岁男性患者，因腹痛、高热、呕吐及腹胀3天就诊。体格检查发现，他血压低、心动过速且发热。腹部膨隆、压痛，肠鸣音减弱。其他系统未发现明显相关异常。实验室检查显示白细胞增多、血小板减少及肝酶升高。在进行复苏优化并开始使用抗生素后，实施了剖腹手术。术中发现有300毫升血性液体、盲肠和升结肠缺血以及腹膜后坏死。随后，进行了多次清创及带造口的右半结肠切除术。尽管在重症监护病房密切监测，患者仍死于无法控制的脓毒症。
坏死性筋膜炎（NF）是一种进展迅速的感染性疾病，需要紧急干预。虽然腹膜后受NF影响很少见，但死亡率很高。腹膜后NF的症状不具特异性，难以诊断。在此，我们报告一例腹膜后NF病例，其具有类似阑尾炎穿孔的全身性腹膜炎体征和症状。
当患者出现全身性腹膜炎病例时，将腹膜后NF作为潜在鉴别诊断很重要。
