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Cecal perforation presenting as abdominal-wall necrotizing fasciitis
1Section of Pediatric Surgery, Department of Surgery, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, Taiwan, Republic of China 70428.
Pediatric Surgery International
|April 24, 2001
Summary
Diagnosing cecal perforation with Salmonella infection causing abdominal-wall necrotizing fasciitis (AWNF) is challenging. CT scans revealing pneumoscrotum and pneumoperitoneum suggest a pathway for infection spread, necessitating laparotomy.
Area of Science:
- Surgical pathology
- Infectious disease
- Radiology
Background:
- Abdominal-wall necrotizing fasciitis (AWNF) can arise from intra-abdominal sources.
- Cecal perforation, particularly due to Salmonella, presents diagnostic challenges for AWNF.
Observation:
- Computed tomography (CT) of the abdomen is a valuable diagnostic tool.
- CT can identify the combined presence of pneumoscrotum and pneumoperitoneum.
Findings:
- Pneumoscrotum and pneumoperitoneum on CT indicate a patent processus vaginalis.
- A patent processus vaginalis serves as a conduit for intra-abdominal infections to spread to the abdominal wall.
Implications:
- Early diagnosis of cecal perforation is crucial to prevent delayed treatment of AWNF.
- Exploratory laparotomy is recommended to confirm intra-abdominal pathology when suspected.