Complicated acute appendicitis presenting as a necrotizing fasciitis of the abdominal wall: a case report

Year 2018, Volume: 4 Issue: 4, 429 - 431, 04.10.2018

Betül Tiryaki Baştuğ , Berkay Subaşı , Emre Emekli , Kübra Parpucu Mahmut Kebapçı

https://doi.org/10.18621/eurj.346464

Abstract

Acute
appendicitis is one of the most common surgical diseases, but necrotizing
fasciitis of the abdominal wall because of perforation is extremely rare. A
50-year-old male presented to the emergency department with severe right-sided
abdominal pain for a week. He was hypothermic, hypotensive, and tachycardic.
His abdomen was distended, with a large, tender, erythematous region over the
right abdominal wall. Laboratory evaluation revealed leukocytosis, acute kidney
injury. Computed tomography revealed large collections of fluid and gas in the
right abdominal wall as well as inflammation surrounding the right colon. The
patient was resuscitated with intra-venous fluid, started on broad-spectrum
antibiotics, and emergently brought to the operating room. The patient
underwent an exploratory laparotomy, and was found to have appendicitis, which
perforated into his abdominal wall resulting in a necrotizing soft tissue
infection. It is important to recognize this complication early and proceed
immediately to the operating room.

Keywords

Perforated appendicitis, abdominal wall abscess, necrotizing fasciitis

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