Abdominal necrotizing fasciitis due to perforated colon cancer

National Taiwan University, T’ai-pei, Taipei, Taiwan
Journal of Emergency Medicine (Impact Factor: 0.97). 02/2006; 30(1):95-6. DOI: 10.1016/j.jemermed.2005.03.014
Source: PubMed
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    • "It is well known that perineal NF, termed as "Fournier's gangrene," is caused by rectal cancer or periproctal abscess[4], and there are several reports on NF due to colorectal cancer involving the abdominal wall[5,6]. However, NF of the thigh due to the spread of colorectal cancer, as observed in the present case, is extremely rare. "
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    ABSTRACT: Necrotizing fasciitis of the thigh due to the colon cancer, especially during chemotherepy, has not been previously reported. A 67-year-old man admitted to the hospital was diagnosed with sigmoid colon cancer that had spread to the left psoas muscle. Multiple hepatic metastases were also found, and combination chemotherapy with irinotecan and S-1 was administered. Four months after the initiation of chemotherapy, the patient developed gait disturbance and high fever and was therefore admitted to the emergency department of our hospital. Blood examination revealed generalized inflammation with a high C-reactive protein level. Computed tomography of the abdomen and pelvis showed gas and fluid collection in the retroperitoneum adjacent to the sigmoid colon cancer. The abscess was locally drained under computed tomographic guidance; however, the infection continued to spread and necrotizing fasciitis developed. Consequently, emergent debridement was performed. The patient recovered well, and the primary tumor was resected after remission of the local inflammation. Necrotizing fasciitis of the thigh due to the spread of sigmoid colon cancer is unusual, but this fatal complication should be considered during chemotherapy for patients with unresectable colorectal cancer.
    World Journal of Surgical Oncology 10/2009; 7(1):74. DOI:10.1186/1477-7819-7-74 · 1.41 Impact Factor
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    ABSTRACT: Anaerobic soft tissue infections are still life-threatening infections. Even if uncommon nowadays, they remain severe conditions because often associated with major systemic effects leading to patient death if not promptly recognized and aggressively treated. Their origins are often traumatic or surgical but they can also develop from an ulcer or a small wound in patients at risk (i.e. diabetics, patients with peripheral vascular disease, etc). Hypoxia, traumatic muscle injury, heavy bacterial contamination as well as errors in antibiotic prophylaxis are major causes. Treatment includes antibiotic therapy adapted to both the anaerobic and associated aerobic bacteria; early and extensive surgical debridement; and intensive Hyperbaric Oxygen Therapy (HBO). Unfortunately, physicians are insufficiently aware of the first sign of these infections which explains why the management is often inadequate initially. Strict preventive measures must be taken to avoid their occurrence
    12/2005: pages 263-289;
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    ABSTRACT: Necrotizing fasciitis is a devastating soft tissue infection affecting fascias and subcutaneous soft tissues. Literature reviews have identified several related risk factors, including malignancy, alcoholism, malnutrition, diabetes, male gender and old age. There are only scanty case reports in the literature describing its rare association with colorectal malignancy. All published cases are attributed to bowel perforation resulting in necrotizing fasciitis over the perineal region. Isolated upper or lower limb diseases are rarely identified. Simultaneous upper and lower limb infection in colorectal cancer patients has never been described in the literature. We report an unusual case of multi-limb necrotizing fasciitis in a patient with underlying non-perforated rectal carcinoma.
    World Journal of Gastroenterology 09/2006; 12(32):5256-8. · 2.37 Impact Factor
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