The squelching hip: a sign of life-threatening sepsis following haemorrhoidectomy.
We report a case of fulminating infection tracking from the left ischiorectal fossa to the popliteal fossa as a consequence of rectal perforation 11 days following traditional Milligan-Morgan haemorrhoidectomy. The case presented as a loud squelching noise coming from the hip on walking. Extensive cellulitis was evident over the posterior aspect of the thigh, with a deep fluctuant collection in the left buttock that communicated with the posterior compartment of the thigh. Per rectal examination revealed a defect in the rectal wall, with a foul-smelling discharge. Extensive thigh incision and drainage, defunctioning colostomy, multiple washouts, and split skin grafting procedures were performed. The patient has now recovered.
Department of Orthopaedics, Royal United Hospital, Bath, UK. jberstock@googlemail.com
James Robert
JR
Berstock
John
J
Bunni
Alexander Peter
AP
Torrie
D000368:Aged; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology; D006484:Hemorrhoids / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D008297:Male; D009622:Noise; D011183:Postoperative Complications / Q000175:diagnosis*; D012002:Rectal Diseases / Q000209:etiology; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology