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Catastrophic necrotizing fasciitis after blunt abdominal trauma with delayed recognition of the coecal rupture--case

Vanja Pecic1, Milica Nestorovic2, Predrag Kovacevic3

  • 1Clinic for General Surgery, Clinical Center Nis, Nis, Serbia. acrepus@yahoo.com.

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|April 18, 2014
PubMed

Insights

Necrotizing fasciitis (NF) is a severe bacterial infection. This case highlights a lethal outcome following blunt abdominal trauma, emphasizing the need for prompt surgical intervention for intestinal rupture.

Area of Science:

  • Infectious Diseases
  • Surgical Pathology
  • Trauma Surgery

Background:

  • Necrotizing fasciitis (NF) is a rare, rapidly progressing bacterial infection causing extensive tissue necrosis.
  • NF can lead to severe morbidity and mortality if not promptly diagnosed and treated.

Observation:

  • A 27-year-old male presented with abdominal pain and hematoma after blunt abdominal trauma.
  • Initial treatment focused on trauma management; however, the patient's condition worsened.
  • Urgent surgery revealed cecal rupture, peritonitis, and abdominal wall infection, followed by fulminant necrotizing fasciitis.

Findings:

  • Despite surgical intervention, necrectomies, and broad-spectrum antibiotics, the patient developed multiple organ dysfunction syndrome (MODS).
  • Reconstruction of the abdominal wall was achieved with skin grafts.
  • The patient succumbed to complications, including lung infection and MODS, 42 days post-operation.

Implications:

  • Blunt abdominal trauma can precipitate intestinal rupture, necessitating emergency laparotomy if peritoneal irritation is present.
  • Early recognition and aggressive management of abdominal trauma complications, such as NF, are critical.
  • This case underscores the potentially fatal consequences of delayed diagnosis and treatment in severe abdominal trauma with secondary infections.

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