Guillermo Cabriada García (Burgos / ES), Romina Parra Lopez (Burgos / ES), Cristina Gonzalez Prado (Burgos / ES), Miguel Angel Alvarez Rico (Burgos / ES), Luis Casaval Cornejo (Burgos / ES), David Jorge Tejedor (Burgos / ES), Idoia Dominguez Arroyo (Burgos / ES), Lucia Polanco Perez (Burgos / ES), Michelle C. Otero Rondon (Burgos / ES), Nerea Muñoz Plaza (Burgos / ES), Carlos Cartón Hernandez (Burgos / ES)
Abstract text (incl. references and figure legends)
CASE HISTORY
An 86 yo. female who presented to the emergency departmet with a 24hour clinical course of fever and hypotension. The patient reported an abdominal hematoma since the previous week when his lumbar belt was adjusted.
The patient medical history was significant for: type 2 diabetes, asthma, AF and a recent L4 compression.
CLINICAL FINDINGS
The patients blood pressure was 96/54, pulse rate was 103 with regular rate and rhythm, and his temperature was 37.4ºC.
The physical examination revealed a gangrenous lessions on the hypogastric area.
INVESTIGATION/RESULTS
The patient was stabilized, antibiotic treatment started and a blood analysis and an abdominal CT were made.
The analysis showed a mild leucocitosis and an acute renal failure with no other significant alterations.
The abdominal CT described a necrotiziting fasciitis of the anterior abdominal wall.
DIAGNOSIS
Necrotiziting fasciitis of the abdominal wall.
THERAPY AND PROGRESSIONS
With those results we decided to take the patient to the operating room.
A complete debridation of all the necrotic tissue was performed, including all the infraumbilical and left lumbar area.
Although all the treatment administrated by the intensive care unit the patient didn´t respond and passed away 72h after the surgery.
COMENTS
The necrotizating soft tissue infections are a important disseases due to its fast progresión and high mortality. A early treatment clearly influence the prognosis.
Even though surgeons are used to the Fournier´s perineal gangrene, we don´t have to forget that it can appear in any other location and, such as in this case, it can develope from a minor wound.
This should be in every surgeons mind at the time we inspect any soft tissue infection so we can treat it fast and effectively.
REFERENCES
Sartelli, M et al. 2018 WSES/SIS-E consensus conference:recommendations for the management of skin and soft-tissue infections. World J Emerg Surg 13, 58 (2018).
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