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- Title
A case study of abdominal wall and limb necrotizing fasciitis: an extremely rare post -operative complication.
- Authors
Sakhri, Saida; Krimi, Ons; Khessairi, Nayssem; Abidi, Fethia; Slimane, Maher; Bouaziz, Hanen; Dhiab, Tarek Ben
- Abstract
Introduction: Infectious affections are the most frequent post-operative complications, the rate have been reducing due to the administration of perioperative antibiotics and they are rarely serious. They are usually associated to pelvic collections, fistulas, urinary tract stenosis and, exceptionally, necrotizing fasciitis (FN) and pelvic organ necrosis. There is no well-codified treatment. Case presentation: A 42-year-old female patient, was referred to our department for a stage IIIC2 adenocarcinoma of the uterine cervix. Two months after surgery, the patient presented with fever. Abdominal CT scan revealed a recto-vaginal fistula. The patient underwent a surgical evacuation of the collection and a bypass colostomy. Post-operative period was marked by the occurrence of an extensive necrosis to pelvic organs and medial left leg's thigh compartments muscles. She also presented a thrombosis of the left external iliac vein and artery. Given the septic conditions, a revascularization procedure was not feasible. A bilateral ureterostomy was required and a ligature of the left external iliac vessels. Then she received palliative treatment.she died one month after surgery because of multivisceral failure due to sepsis. Conclusion: Necrotizing fasciitis is extremely rare and serious condition, the diagnosis is clinical and radiological, CT scan is helpful for the. There are predisposing factors such as diabetes, neoadjuvant radiotherapy or chemotherapy. The prognosis can be improved with rapid management and appropriate medical and surgical excisions of necrotic tissue, and antibiotic therapy adapted to the suspected germs, essentially anaerobic ones. Highlights: • Necrotizing lesions of softs tissus are an extremely rare complication in routine surgical practice. • The diagnosis of necrotizing fasciitis is difficult and based on clinical symptoms, the particularities of the mixed infection, and predisposing factors of the patient. • The Treatment is based on an urgent and intensive surgical debridement with targeted application of broad-spectrum antibiotics.
- Subjects
NECROTIZING fasciitis; ABDOMINAL wall; CERVIX uteri; SURGICAL complications; ILIAC vein; SURGICAL excision; COLOSTOMY; DEBRIDEMENT
- Publication
BMC Women's Health, 2024, Vol 24, Issue 1, p1
- ISSN
1472-6874
- Publication type
Article
- DOI
10.1186/s12905-024-03084-1