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Retroperitoneal Necrotizing Soft Tissue Infection in a Healthy Adult Masquerading as Acute Pancreatitis

Nitin Agarwal1, Mohammad Shazib Faridi1, Pradeep Saini1

  • 1Department of Surgery, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India.

Acta Medica Iranica
|February 12, 2017
PubMed

Insights

Necrotizing soft tissue infections (NSTIs) are severe polymicrobial infections. A rare case presented retroperitoneal NSTI mimicking pancreatitis, successfully treated with debridement and antibiotics.

Area of Science:

  • Infectious Diseases
  • Surgical Pathology
  • Medical Imaging

Background:

  • Necrotizing soft tissue infections (NSTIs) are severe polymicrobial infections characterized by high morbidity and mortality.
  • Early diagnosis and prompt surgical intervention are crucial for managing NSTIs.

Observation:

  • A case of retroperitoneal NSTI in an immunocompetent young male is presented.
  • Clinical presentation mimicked acute pancreatitis, with pseudo-Cullen's and pseudo-Grey-Turner's signs.
  • The infection originated from a pustule and progressed to involve the retroperitoneum.

Findings:

  • Computed tomography (CT) scan revealed features consistent with retroperitoneal NSTI.
  • Extensive surgical debridement and antibiotic therapy were administered.
  • The patient demonstrated clinical improvement following treatment.

Implications:

  • Retroperitoneal NSTI is a rare but serious condition.
  • The absence of external signs and anatomical barriers pose diagnostic and management challenges.
  • This case highlights the importance of considering NSTI in the differential diagnosis of abdominal pain, even with atypical presentations.
Keywords:
Acute painAcute pancreatitisInfection

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