Strangulated femoral hernia leading to lower extremity necrotizing soft tissue infection

This article presents a rare case of a necrotizing soft tissue infection secondary to a strangulated and perforated femoral hernia. The patient had presented several days after the onset of symptoms and was in septic shock due to spillage of intestinal contents into the thigh. Urgent operative management was undertaken to obtain source control and debride the significant necrotic tissue that was present. Additionally, small bowel resection via a midline laparotomy was required as the bowel was necrotic on intraoperative evaluation. Specific management challenges included the closure of hernia defect in an infected field and the complex wound care regimen necessitated by the extent of tissue necrosis. Prompt surgical intervention, in the setting of a necrotizing soft tissue infection, is imperative to achieving a favorable outcome.