European Journal of Biomedical and Pharmaceutical Sciences

AN UNCOMMON PRESENTATION OF ANTERIOR ABDOMINAL WALL NECROTIZING FASCIITIS EXTENDING FROM PERIANAL PUS COLLECTION THROUGH RETROPERITONEAL AND EXTRAPERITONEAL ROUTES: A CASE REPORT

Sofyan El-khatib* MD, Belal alabdallat MD, Ali Metred Aloun MD, Ahmad Mahasna MD and Ehab Mohammad Mustafa MD

ABSTRACT

Introduction: Necrotizing fasciitis, a severe and promptly advancing soft tissue infection, is a medical emergency with a high death rate. While it typically involves the Limbs and perineal regions, we present an extraordinary case of anterior abdominal wall necrotizing fasciitis that originated from a perianal pus collection and extended through retroperitoneal and extraperitoneal routes, notably sparing the intraperitoneal and pelvic spaces. Case Presentation: Our patient, a 45-year-old male with a history of ischemic heart disease, initially presented to our emergency department of King Hussein medical hospital with perianal pain and fever. He received prompt medical attention, including incision and drainage of the perianal abscess along with intravenous antibiotics. However, a week later, his condition deteriorated as he developed necrotizing fasciitis affecting the anterior abdominal wall. This unique presentation required immediate surgical intervention and drainage of both the perianal and anterior abdominal wall regions. Additionally, the patient received supportive parenteral nutrition and vacuum assisted dressing to aid in his recovery. While there have been observable clinical and laboratory improvements, the patient continues to receive wound management care as part of his journey towards full recovery. Conclusion: This case report underscores the exceptional nature of this presentation and aims to enhance our comprehension of the clinical characteristics, management strategies, and the challenges posed by this unusual manifestation of necrotizing fasciitis. Such cases are exceedingly rare, making the documentation and dissemination of this case vital for the medical community's understanding and awareness.

Keywords: Necrotizing fasciitis, anterior abdominal wall, perianal infection, retroperitoneal space, extraperitoneal space.