NECROTIZING FASCIITIS FOLLOWING ABDOMINAL BLUNT TRAUMA -A CASE REPORT-

Necrotizing fasciitis is a relatively uncommon in fection of the fascia and soft-tissue. It is often associated with severe injuries. Sometimes it has been reported as a complication after laparotomy when we surgeons tend to lack of understanding about the infection and the prognosis of such patient is poor. This time we experienced a case of necrotizing fasciitis following an abdominal blunt trauma. A 60-year-old man was admitted to the hospital because of an abdominal external injury. An emergency abdominal exploration revealed approximately 1500 ml of blood in the abdominal cavity, and the ruptured jejunum and sigmoid colon. Two weeks after the operation redness developed to form bullae in the left upper quadrant where was not injured site. Six days later the skin lesion started to necrose. With an advance of necrosis, the patient fell into septic shock. The diagnosis of necrotizing faciitis was made by clinical findings and histological features. Surgical debridement of necrotic tissues was repeated every day. The patient was discharged from the hospital 5 months after the emergency laparotomy. Early diagnosis and rapid initial surgical debridement of necrotizing fasciitis which can be fatal even by today's advanced chemotherapy are important to save patients.