Complicated diverticular disease debuting as necrotising fasciitis of pelvic limb. A case report
| Autor: | Claudia Gutiérrez-Alfaro, Cuauhtly Gallegos-Sierra, Gerardo Evaristo-Méndez |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Necrotising fasciitis Ocean Engineering 030230 surgery Diverticulitis Colonic Fasciotomy 03 medical and health sciences Fatal Outcome 0302 clinical medicine Humans Medicine Fasciitis Necrotizing Abscess Leg Crepitus business.industry Cellulitis Middle Aged Diverticulitis medicine.disease Systemic Inflammatory Response Syndrome Surgery medicine.anatomical_structure Debridement Intestinal Perforation Diverticular disease Buttocks Abdomen Female 030211 gastroenterology & hepatology Radiology medicine.symptom Tomography X-Ray Computed business Low Back Pain Negative-Pressure Wound Therapy |
| Zdroj: | Cirugía y Cirujanos (English Edition). 85:240-244 |
| ISSN: | 2444-0507 |
| Popis: | Diverticular disease, and the diverticulitis, the main complication of it, are widely studied diseases with multiple chronic cases reported in the literature, but there are no atypical presentations with extra-abdominal symptoms coupled with seemingly unrelated entities, such as necrotising fasciitis.Female 52 years old, was admitted to the emergency department with back pain of 22 days duration. History of importance: Chronic use of benzodiazepines intramuscularly. Physical examination revealed the presence of a gluteal abscess in right pelvic limb with discoloration, as well as peri-lesional cellulitis and crepitus that stretches across the back of the limb. Fasciotomy was performed with debridement of necrotic tissue. Progression was torpid with crackling in abdomen. Computed tomography showed free air in the cavity, and on being surgically explored was found to be complicated diverticular disease.It is unusual for complicated diverticular disease to present with symptoms extra-peritoneal (2%) and even more so that a diverticulitis is due to necrotising fasciitis (1%). The absence of peritoneal manifestations delayed the timely diagnosis, which was evident with the crackling of the abdomen and abdominal computed tomography scan showing the parietal gaseous process.All necrotising fasciitis needs an abdominal computed tomography scan to look for abdominal diseases (in this case diverticulitis), as their overlapping presentation delays the diagnosis and consequently the treatment, making a fatal outcome inevitable. |
| Databáze: | OpenAIRE |
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