Hip Pelvis.  2013 Jun;25(2):149-152. 10.5371/hp.2013.25.2.149.

Necrotising Fascitis of the Thigh through Short External Rotator Muscles Due to an Unrecognized Perforated Rectal Cancer

• Kim JO
• Cho HM
• Sin WJ
• Bong HS

• KMID: 2054154
• DOI: http://doi.org/10.5371/hp.2013.25.2.149

Abstract

Necrotizing fasciitis is one of the few true emergencies in orthopedic surgery that has a very high mortality rate unless recognized promptly and treated aggressively. The authors report a case of a patient with necrotizing fasciitis on the thigh that developed secondary to an unrecognized rectal cancer perforation through the short external rotator muscles. Clinicians should always be alert to the potential that rectal cancer perforations can cause necrotizing fasciitis in rare cases.

Keyword

Necrotizing fascitis; Rectal cancer; Perforation; Thigh

MeSH Terms

Emergencies
Fasciitis
Fasciitis, Necrotizing
Humans
Muscles
Orthopedics
Rectal Neoplasms
Thigh

Figure

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  Fig. 1 (A) An initial radiograph shows subcutaneous emphysema of the thigh. (B) CT reveals subcutaneous emphysema involving the soft tissues of the left thigh and fluid collections most compatible with abscesses.

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  Fig. 2 An intraoperative photograph shows purulent pus discharge from the wound and necrosis of fascia, infiltration of pus along the fascial plane and vastus lateralis muscle.

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  Fig. 3 Abdominopelvic CT shows a rectal malignancy with lymph nodes in perirectal space and inferior mesenteric chain and multiple abscess pockets in left pelvis & scanned thigh muscles with fistula.

Reference

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