title: A successfully treated case of severe necrotizing fasciitis caused by acute appendicitis: a case report.
abstract: We successfully saved a patient with appendicitis followed by necrotizing fascitis. A 77-year-old man with a history of ambulatory treatment for depression underwent an emergency operation because of severe abdominal pain. Laparotomy demonstrated that necrotizing appendicitis was massively extending over the abdominal cavity, involving the right paracolic sulcus and Douglas pouch and posterior surface of the right kidney. Irrespective of the emergency surgery, redness and swelling in the right chest and abdomen, which was noted at the time of admission, was not decreased. Successively, a retension incision was performed under the diagnosis of necrotizing fasciitis. Necrotizing fasciitis is an extremely rare complication of appendicitis, and there were only 10 cases documented. Once necrotizing fasciitis occurs, the mortality rate is high, so that correct diagnosis and prompt debridement are mandatory. Particularly for elderly patients with appendicitis, rapid and accurate diagnosis and treatment are required.
authors.affiliation: Department of Surgery, Tokai University Oiso Hospital, Kanagawa, Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Mukoyama
authors.forename: Masaya
authors.initials: M
authors.lastname: Mukai
authors.forename: Seiei
authors.initials: S
authors.lastname: Yasuda
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Oida
authors.forename: Shinji
authors.initials: S
authors.lastname: Himeno
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishi
authors.forename: Hisao
authors.initials: H
authors.lastname: Nakasaki
authors.forename: Hirotada
authors.initials: H
authors.lastname: Iwase
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuda
authors.forename: Sotaro
authors.initials: S
authors.lastname: Sadahiro
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000208:Acute Disease; D000368:Aged; D001064:Appendicitis / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome