Tissue-conserving, yet radical surgery for extensive gas-forming soft tissue infections arising from perirectal abscess: report of a case

Surg Infect (Larchmt). 2012 Oct;13(5):332-5. doi: 10.1089/sur.2011.047. Epub 2012 Oct 5.

Abstract

Background: Perirectal abscess is encountered commonly in surgical practice, and simple incision and drainage usually is sufficient. However, life-threatening sepsis may occur. In such instances, the high morbidity and mortality rates from the severe systemic inflammatory response syndrome (SIRS) associated with rapidly evolving necrotizing and gas-forming soft tissue infections are of major concern.

Methods: Case report and review of pertinent literature.

Results: A rare case of extensive necrotizing fasciitis of the torso arising from a perirectal abscess, in which the principles of radical surgical debridement were adhered to while minimizing disfigurement, is reported in a 19-year-old female. In some cases, despite the life-threatening nature of necrotizing fasciitis, it is possible to minimize tissue loss without compromising patient survival.

Conclusion: Planning of the patient's site rehabilitation for maximum cosmetic outcome commences at the time of surgical debridement and is especially important for the young patient.

Publication types

  • Case Reports

MeSH terms

  • Abdomen / pathology
  • Abdomen / surgery
  • Abdominal Abscess / microbiology*
  • Abdominal Abscess / surgery
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Debridement / methods
  • Fasciitis, Necrotizing / microbiology*
  • Fasciitis, Necrotizing / surgery*
  • Female
  • Humans
  • Negative-Pressure Wound Therapy / methods
  • Rectal Diseases / microbiology*
  • Rectal Diseases / surgery
  • Young Adult

Substances

  • Anti-Bacterial Agents