J Korean Surg Soc.
2004 Jul;67(1):70-74.
Necrotizing Fasciitis Secondary to Perforated Appendicitis
- Affiliations
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- 1Department of Surgery, University of Ulsan Medical College, Seoul Asan Hospital, Seoul, Korea. ypcho@gnah.co.kr
- 2Department of Surgery, University of Ulsan Medical College, Gangneung Asan Hospital, Gangneung, Korea.
- 3Department of Diagnostic Radiology, University of Ulsan Medical College, Gangneung Asan Hospital, Gangneung, Korea.
- 4Department of Anesthesiology, University of Ulsan Medical College, Gangneung Asan Hospital, Gangneung, Korea.
Abstract
- Necrotizing fasciitis is a rapidly progressing soft-tissue infection that affects the subcutaneous fascia and dermis, and characteristically spares the underlying muscle. Most cases represent a synergistic or mixed bacterial infection of aerobes and anaerobes. A variety of etiologies have been reported. Herein, two cases of necrotizing fasciitis of the right thigh secondary to perforated appendicitis, an extremely rare complication, are reported. Both cases recovered following aggressive surgical and medical therapies. The delay in diagnosis and radical surgical excision are frequent and significant contributory factors in the high reported mortality rate. A high index of suspicion, followed by prompt surgical intervention with broad-spectrum antibiotic therapy, seems to be the most important prognostic factor in these difficult cases.
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