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Published in: Journal of Medical Case Reports 1/2012

Open Access 01-12-2012 | Case report

Retroperitoneal necrotizing fasciitis presenting with peritonism in a 33-year-old Nepalese man: a case report

Authors: Smith Giri, Bishnu P Kandel, Prasan BS Kansakar, Pradeep Vaidya

Published in: Journal of Medical Case Reports | Issue 1/2012

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Abstract

Introduction

Retroperitoneal necrotizing fasciitis is a rare, fulminant, and potentially lethal complication of intra-abdominal suppuration. A retroperitoneal origin is very rare and very few cases have been reported in the literature. To the best of our knowledge, this case is only the fourth case reported of successful management following retroperitoneal necrotizing fasciitis.

Case presentation

A 33-year-old Tamang man presented to our facility with a history of five days of fever and vomiting and eight days of severe left loin pain. On examination, he had features of peritonism. A laparotomy was performed, revealing extensive necrotizing fasciitis of the retroperitoneum extending to the anterior abdominal wall. Our patient survived following extensive debridement of the necrotic tissues and supportive care.

Conclusions

Retroperitoneal necrotizing fasciitis can rarely present with features of peritonism, and hence should be included as a possible differential diagnosis for anyone presenting with peritonism. Although a fatal condition, early intervention and aggressive management can save the life of a patient.
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Literature
1.
go back to reference Patino JF, Castro D: Necrotizing lesions of soft tissues: a review. World J Surg. 1991, 15: 235-239. 10.1007/BF01659058.CrossRefPubMed Patino JF, Castro D: Necrotizing lesions of soft tissues: a review. World J Surg. 1991, 15: 235-239. 10.1007/BF01659058.CrossRefPubMed
2.
go back to reference Tununguntla A, Raza R, Hudgins L: Diagnostic and therapeutic difficulties in retroperitoneal abscess. South Med J. 2004, 97: 110-119. Tununguntla A, Raza R, Hudgins L: Diagnostic and therapeutic difficulties in retroperitoneal abscess. South Med J. 2004, 97: 110-119.
3.
go back to reference Takakura Y, Ikeda S, Yoshimitsu M, Hinoi T, Sumitani D, Takeda H: Retroperitoneal abscess complicated with necrotizing fasciitis of the thigh in a patient with sigmoid colon cancer. World J Surg Oncol. 2009, 7: 74-10.1186/1477-7819-7-74.CrossRefPubMedPubMedCentral Takakura Y, Ikeda S, Yoshimitsu M, Hinoi T, Sumitani D, Takeda H: Retroperitoneal abscess complicated with necrotizing fasciitis of the thigh in a patient with sigmoid colon cancer. World J Surg Oncol. 2009, 7: 74-10.1186/1477-7819-7-74.CrossRefPubMedPubMedCentral
4.
go back to reference Pryror JP, Piotrowski E, Seltzer CW: Early diagnosis of retroperitoneal necrotizing fasciitis. Crit Care Med. 2001, 29: 1071-1073. 10.1097/00003246-200105000-00040.CrossRef Pryror JP, Piotrowski E, Seltzer CW: Early diagnosis of retroperitoneal necrotizing fasciitis. Crit Care Med. 2001, 29: 1071-1073. 10.1097/00003246-200105000-00040.CrossRef
5.
go back to reference Ammari JEEL, Ahssaini M, Fassi MJEL, Farih MH: Retroperitoneal necrotizing fasciitis due to chronic pyelonephritis. J Emerg Trauma Shock. 2010, 3: 419-420. 10.4103/0974-2700.70763.CrossRefPubMed Ammari JEEL, Ahssaini M, Fassi MJEL, Farih MH: Retroperitoneal necrotizing fasciitis due to chronic pyelonephritis. J Emerg Trauma Shock. 2010, 3: 419-420. 10.4103/0974-2700.70763.CrossRefPubMed
6.
go back to reference Secil M, Topacoglu H: Retroperitoneal necrotizing fasciitis secondary to colonic diverticulitis. J Emerg Med. 2008, 34: 95-97. 10.1016/j.jemermed.2007.02.059.CrossRefPubMed Secil M, Topacoglu H: Retroperitoneal necrotizing fasciitis secondary to colonic diverticulitis. J Emerg Med. 2008, 34: 95-97. 10.1016/j.jemermed.2007.02.059.CrossRefPubMed
7.
go back to reference Woodburn KR, Ramsay G, Gillespie G, Miller DF: Retroperitoneal necrotizing fasciitis. Br J Surg. 1992, 79: 342-344. 10.1002/bjs.1800790421.CrossRefPubMed Woodburn KR, Ramsay G, Gillespie G, Miller DF: Retroperitoneal necrotizing fasciitis. Br J Surg. 1992, 79: 342-344. 10.1002/bjs.1800790421.CrossRefPubMed
8.
go back to reference Jayatunga AP, Caplan S, Paes TRF: Survival after retroperitoneal necrotizing fasciitis. Br J Surg. 1993, 80: 981-10.1002/bjs.1800800813.CrossRefPubMed Jayatunga AP, Caplan S, Paes TRF: Survival after retroperitoneal necrotizing fasciitis. Br J Surg. 1993, 80: 981-10.1002/bjs.1800800813.CrossRefPubMed
9.
go back to reference Sugimoto M, Matsuura K, Takayama H, Kayo M, Le T: Extended retroperitoneal necrotizing fasciitis with genital involvement resembling Fournier's gangrene. Surg Infect. 2010, 11: 463-467. 10.1089/sur.2008.101.CrossRef Sugimoto M, Matsuura K, Takayama H, Kayo M, Le T: Extended retroperitoneal necrotizing fasciitis with genital involvement resembling Fournier's gangrene. Surg Infect. 2010, 11: 463-467. 10.1089/sur.2008.101.CrossRef
10.
go back to reference Devin B, McCarthy A, Mehran R, Auger CC: Necrotizing fasciitis of the retroperitoneum: an unusual presentation of group A Streptococcus infection. Can J Surg. 1998, 41: 156-160.PubMedPubMedCentral Devin B, McCarthy A, Mehran R, Auger CC: Necrotizing fasciitis of the retroperitoneum: an unusual presentation of group A Streptococcus infection. Can J Surg. 1998, 41: 156-160.PubMedPubMedCentral
Metadata
Title
Retroperitoneal necrotizing fasciitis presenting with peritonism in a 33-year-old Nepalese man: a case report
Authors
Smith Giri
Bishnu P Kandel
Prasan BS Kansakar
Pradeep Vaidya
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-6-53

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