RESUMO
Necrotising fasciitis (NF) is a potentially lethal spread of infection that is uncommonly seen within the province of surgery. Seen mostly in the extremities and the perineal regions, it has been reported rarely to involve the retroperitoneal space and presents with a spectrum of symptoms and signs as such. Literature supports classification of NF based on the microbes involved. Irrespective of the aetiology and the causative organism, NF remains a serious surgical emergency with high morbidity and mortality not only associated with the disease process itself, but also with the extensive surgical debridement it requires in its management along with antimicrobial administration. We present a case of such an infection found in the retroperitoneal space secondary to a perineal infection forming a rare presentation of this deadly process, and how it was successfully managed secondary to timely surgical intervention.
Assuntos
Fasciite Necrosante/diagnóstico por imagem , Períneo/microbiologia , Espaço Retroperitoneal/microbiologia , Administração Intravenosa , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Colostomia/métodos , Corynebacterium/isolamento & purificação , Desbridamento , Fasciite Necrosante/tratamento farmacológico , Fasciite Necrosante/cirurgia , Feminino , Humanos , Jejunostomia/métodos , Laparotomia/métodos , Períneo/diagnóstico por imagem , Períneo/patologia , Períneo/cirurgia , Espaço Retroperitoneal/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
Colorectal foreign bodies (FBs) are not unheard of in the province of surgery. They are commonly seen in men ranging from 20 to 90 years of age with a bimodal age distribution. A variety of objects have been described and reported in literature. Management involves a complete history and examination followed by the necessary investigations. Most of the time they can be removed at bedside with some manipulation techniques employing the use of some ingenious devices and/or endoscopy for adamant objects. But persistent FBs or those that are high in the rectum or those that present with complications will require operative management. We present a case of a 77 cm long FB inserted rectally for sexual gratification in a male patient, which caused a large bowel perforation, ending high intra-abdominally at the level of the spleen and diaphragm after traversing the entire abdominal cavity and requiring a laparotomy for removal.