大腸後腹膜穿通術後に発症した壊死性筋膜炎の２例

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  • TWO CASES OF NECROTIZING FASCIITIS DEVELOPED AFTER OPERATION FOR COLON PENETRATION INTO THE RETROPERITONEUM

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Two cases of necrotizing fasciitis developed after an operation for colon penetration into the retroperitoneum are reported. Case 1 was a 64-year-old man, for whom sigmoidectomy and drainage were performed for sigmoid colon cancer penetration with abscess formation. After operation, redness and swelling at the left femoral developed, and an X-ray showed subcutaneous air. A wide incision drainage and removal of necrosed fascia were perfomed. Culture of the purulent fluid revealed E.coli and Enterococcus feacalis. Case 2 was a 62-year-old man who under went ileocecal resection and drainage for cecum diverticulitis penetrating the retroperitoneum. After operation, redness and pain in the right abdomen developed. An incision at the inflammation site was performed, and underspreading necrotic fascia were observed. Culture of the purulent fluid showed iralic and halic. When redness of the skin accompanied with pain is observed following an operation for colon penetration into the retroperitoneum, surgical treatment must be performed immediately considering the possibility of necrotizing fasciitis.

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