[Necrotizing fasciitis after laparoscopic adhesion surgery. A clinical case].
A case of a fulminating necrotizing cellulitis after a laparoscopic adhesiolysis performed for ileal obstructive disease, is presented. During operation, a very little intestinal perforation was caused by an "atraumatic grasper", and intestinal fluid flooded into the peritoneum; the lesion was sutured. A copious peritoneal lavage was performed and the operation ended by positioning a peritoneal drain. The patient was going well, passing flatus on the second postoperative day; on the fourth postoperative day erythematous edema close one of the trocar wound appeared. In spite of an aggressive medical and surgical therapy the infection had a very rapid spreading and the patient died six days later. A literature review is reported and simple intraoperative remedies are proposed.
Dalla Torre
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A
Divisione di Chirurgia Generale, ASL RMA, Ospedale San Giacomo, Roma.
Cappelloni
M
M
D000368:Aged; D019115:Fasciitis, Necrotizing / Q000209:etiology*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000601:surgery