Necrotizing Fasciitis Secondary to a Primary Suture for Anoperineal Trauma by Motorcycle Accident in a Healthy Adult.
A 41-year-old man experienced a swollen scrotum three days after a motorcycle accident and presented to our hospital. He had had a primary suture repair for anoperineal trauma in an outside hospital at the time of the injury. He presented to us with general fatigue, low grade fevers, and perineal pain. Abdominal computed tomography showed subcutaneous emphysema from the scrotum to the left chest. The sutured wound had foul-smelling discharge and white exudate. We made the diagnosis of necrotizing fasciitis and immediately opened the sutured wound and performed initial debridement and lavage with copious irrigation. We continued antibiotics and lavage of the wound until the infection was controlled. Fortunately, the necrotizing fasciitis did not worsen and he was discharged after 15 days. Our experience indicates that anoperineal injuries should not be closed without careful and intensive follow-up due to the potential of developing necrotizing fasciitis.
Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Susumu
S
Saigusa
Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Masaki
M
Ohi
Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Hiroki
H
Imaoka
Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Ryo
R
Uratani
Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Minako
M
Kobayashi
Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Yasuhiro
Y
Inoue