J Acute Care Surg.  2024 Jul;14(2):63-66. 10.17479/jacs.2024.14.2.63.

A Case of Acute Appendicitis Complicated by Necrotizing Fasciitis Requiring Abdominal Wall Reconstruction

• Lim QX
• Guo Y
• Guang Ho CW
• Zheng X

• KMID: 2557999
• DOI: http://doi.org/10.17479/jacs.2024.14.2.63

Abstract

Acute appendicitis represents one of the most common causes of acute abdomen that may warrant emergency surgery. Necrotizing fasciitis complicated by acute appendicitis is considered a rare complication with life-threatening implications. A 65-year-old man presented with abdominal pain, where a scan, revealed a perforated appendicitis complicated by an anterior abdominal wall collection. He underwent percutaneous drainage, but subsequently developed extensive necrotizing fasciitis requiring extensive debridement and reconstruction. The rapid progression of necrotizing fasciitis calls for early recognition and prompt intervention. The key management principles employed were broad spectrum antibiotics and aggressive surgical debridement. This case demonstrated the use of vacuum-assisted closure dressing and multidisciplinary care in wound healing and coverage. To ensure early diagnosis and intervention for acute appendicitis complicated by necrotizing fasciitis, a high degree of clinical suspicion and awareness of this complication is required.

Keyword

abdominal wall, appendicitis, debridement, necrotizing fasciitis