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Necrotizing Fasciitis – A Rare Complication of Laparoscopic Appendectomy


Authors: R. Svatoň;  C. Neumann;  M. Hanslianová 1
Authors‘ workplace: Chirurgická klinika Lékařské fakulty Masarykovy Univerzity a Fakultní nemocnice Brno přednosta: prof. MUDr. Zdeněk Kala, CSc. ;  Oddělení klinické mikrobiologie Fakultní nemocnice Brno, primář: MUDr. Alena Ševčíková 1
Published in: Rozhl. Chir., 2009, roč. 88, č. 1, s. 35-39.
Category: Monothematic special - Original

Overview

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.

Key words:
necrotizing fasciitis – laparoscopic appendectomy – complications


Sources

1. Groth, D., Henderson, S. O. Necrotizing fasciitis due to appendicitis. American Journal of Emergency Medicíně, 1999 Oct, roč. 17, č. 6, s. 594–596.

2. Sudarsky, L. A. Laschinger, J. C. Coppa, G. F., Spencer, F. C. Improved results from a standardized approach in treating patients with necrotizing fasciitis. Annals of Surgery, 1987 Nov, roč. 206, č. 5, s. 661–665.

3. Wysoki, M. G., Santora, T. A., Shah, R. M., Friedman, A. C. Necrotizing fasciitis: CT characteristics. Radiology, 1997 Jun, roč. 203, č. 3, s. 859–863.

4. Jatagandzidis, V., Herdegen, P., Mráček, M., Levý, M., Štefka, J. Complications of the laparoscopic appendectomy. Rozhl. Chir., 2007 Jun, roč. 86, č. 6, s. 288–289

5. Aziz, O., Athanasiou, T., Tekkis, P. P., Purkayastha, S., Haddow, J., Malinovski, V., Paraskeva, P., Darzi, A. Laparoscopic versus open appendectomy in children: a meta-analysis. Annals of Surgery, 2006 Jan, roč. 243, č. 1, s. 17–27.

6. Guller, U., Hervey, S., Purves, H., Muhlbaier, L. H., Peterson, E. D., Eubanks, S., Pietrobon, R. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Annals of Surgery, 2004 Jan, roč. 239, č. 1, s. 43–52.

7. Gupta, R., Sample, C., Bamehriz, F., Birch, D. W. Infectious complications following laparoscopic appendectomy. Canadian Journal of Surgery, 2006 Dec, roč. 49, č. 6, s. 397–400.

8. Mukoyama, S., Mukai, M., Yasuda, S., Oida, Y., Himeno, S., Nishi, T., Nakasaki, H., Iwase, H., Yasuda, M., Sadahiro, S., Makuuchi, H. A successfully treated case of severe necrotizing fasciitis caused by acute appendicitis: a case report. Tokai Journal of Experimental Clinical Medicine, 2003 Oct, roč. 28, č. 3, s. 139–143.

9. Wilson, B. Necrotizing Fasciits. Am. Surg., 1952, roč. 18, s. 416–431.

10. Fournier, J. A. Gangrene foudroyant de la verge. Semaine Med., 1883, roč. 3, s. 345–347.

11. Taviloglu, K., Yanar, H. Necrotizing fasciitis: strategies for diagnosis and management. World J. Emerg. Surg., 2007 Aug, roč. 2, s. 19.

12. Devin, B., McCarthy, A., Mehran, R., Auger, C. Necrotizing fasciitis of the retroperitoneum: an unusual presentation of group A  Streptococcus infection. Canadian Journal of Surgery, 1998 Apr, roč. 41, č. 2, s. 156–160.

13. Sotrel, G., Hirsch, E., Edelin, K. C. Necrotizing fasciitis following diagnostic laparoscopy. Obstetrics Gynekology, 1983 Sep, roč. 62, č. 3 Suppl, s. 67–69.

14. Lodha, A., Wales, P. W., James, A., Smith, C. R., Langer, J. C. Acute appendicitis with fulminant necrotizing fasciitis in a neonate. Journal of Pediatrie Surgery, 2003 Nov, roč. 38, č. 11, s E5–6

15. Stone, G. Gorbach, S. Necrotizing fasciitis: The changing spectrum. Dermatos. Clin., 1997, roč. 15, s. 213–220.

16. Bobrow, B. J., Mohr, J., Pollack, C. V. Jr. An unusual complication of missed appendicitis. Journal of Emergency Medicine, 1996 Nov-Dec, roč. 14, č. 6, s. 719–722.

17. Mazza, J. F. Jr., Augenstein, J. S., Kreis, D. J. Jr. Necrotizing fasciitis: a rare complication of appendicitis. Southern Medical Journal, 1987 Sep, roč. 80, č. 9, s. 1197–1198.

18. Penninga, L., Wettergren, A. Perforated appendicitis during near-term pregnancy causing necrotizing fasciitis of the lower extremity: a rare complication of a common disease. Acta Obstetricia et Gynecologica Scandinavica, 2006, roč. 85, č. 9, s. 1150–1151.

19. Trča, S., Šváb, J. Závažné komplikace po prosté apendektomii. Rozhl. Chir., 2008, roč. 87, č. 8, s. 413–416.

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Surgery Orthopaedics Trauma surgery
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