Necrotizing fasciitis--a rare complication of laparoscopic appendectomy

• Published in: Rozhledy v chirurgii Vol. 88; no. 1; p. 35
• Main Authors: Svaton, R, Neumann, C, Hanslianová, M
• Format: Journal Article
• Language: Czech
• Published: Czech Republic 01.01.2009
• Subjects: Adult; Appendectomy - adverse effects; Fasciitis, Necrotizing - diagnosis; Fasciitis, Necrotizing - etiology; Fasciitis, Necrotizing - therapy; Humans; Laparoscopy - adverse effects; Male; Surgical Wound Infection - diagnosis; Surgical Wound Infection - microbiology; Surgical Wound Infection - therapy
• ISSN: 0035-9351

Necrotizing fasciitis is a bacterial infectious disorder affecting the fascia and the dermis, however sparing the muscle layer. Initial, difficult to detect, fast-progressing subcutaneous spread with rapid progression to shock, conduces to the high mortality rates of the disorder. In risk patient groups, such as in diabetes patients, immunocompromized patients or the elderly, the mortality rate even exceeds 80%. The majority of infections is caused by common skin, rectal or urethral bacteria. The commonest paths of entry into the body include minor skin lesions, including surgical wounds. Fever, pain, skin redness and edema, crepitus and, later even skin necrosis mimicking grade III burns, are the symptoms suggestive of necrotizing fasciitis. Among depicting methods, CT examination is irreplacable. Only early and sufficiently radical surgical management with adjunctive antibiotic therapy may result in successful outcomes. The authors present a rare case of necrotizing fasciitis, which developed as a complication of laparoscopic appendectomy in a young healthy subject. Considering the rarity of the complication, a summary of available medical literature data related to the problematics is included in this presentation.