title: [Necrotizing dermohypodermitis of the abdominal wall in obesity. Two cases indicative of abdominopelvic deep infection].
abstract: Necrotizing dermohypodermitis of abdominal wall in obese is a rare disease with high mortality. We report two cases of 50 and 62years old patients whose intra-abdominal infectious pathology (appendicular abscess for one and pyosalpinx for the other) was revealed by a necrotizing dermohypodermitis of the abdominal wall. The diagnosis has been established on the basis of converging clinical arguments (abdominal pain, crackles and necrotic appearance of abdominal wall in a septic shock context), linked with a CT-scan. The treatment consisted of a large excision of the abdominal wall necrosis and surgical eradication of deep infection source, with an intensive care and a broad spectrum antibiotic therapy. Both these patients present morbid obesity (BMI>40) whose implication must be taken into consideration in the way the disease appears. Indeed, the necrotizing dermohypodermitis of abdominal wall in these patients must lead first in looking for a deep infection with few symptoms. It must be identified quickly to propose an early and multidisciplinary surgical treatment.
authors: Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, hôpital Charles-Nicolle, CHU de Rouen, 1 rue de Germont, Rouen, France. a.pegot@hotmail.fr
authors: A
authors: A
authors: Pegot
authors: A
authors: A
authors: Aktouf
authors: V
authors: V
authors: Delpierre
authors: P-Y
authors: PY
authors: Milliez
authors: I
authors: I
authors: Auquit-Auckbur
mesh_terms: D034861:Abdominal Wall / Q000473:pathology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents