Necrotizing Fasciitis as an Early Postoperative Complication of Non-perforated Non-metastatic Rectal Cancer: Case Report and a Review of the Literature

Abstract

Background: Necrotizing fasciitis is a life-threatening condition characterized by a rapid onset and aggressive degradation of the patient’s condition due to its fair prognosis. The brisk rate of necrotizing fasciitis evolution often makes diagnosing and treating it difficult, thus becoming fatal and incompatible with life.

Case report: The authors report a rare case of a 62 years old woman, who had undergone a laparoscopic anterior rectal resection intervention. The patient presented stable with no co-morbidities. She had suffered different gastrointestinal symptoms during the last 2 months such as anorexia, diarrhea, and abdominal discomfort. She had also lost 6 kg in a 2-month time period. Imaging examinations (contrast CT) detected a rectal tumor stage CT4a N1 M0. No bowel perforations were detected. The team faced no perioperative complications. Later that day, she referred to having moderated pain around the surgical wounds that developed two days later with pain and mild diffuse hematoma in the left flank. This developed into necrotizing fasciitis and despite all the efforts she had an exitus lethalis on the 9^th postoperative day.

Conclusions: Necrotizing fasciitis still remains a challenge to many specialists. In the context of malignancies, it is sometimes seen as a complication of perforated colon tumors. However, cases such as this, represent a challenge to many doctors due to their insidious characteristics. That is why it is important to search further into the mechanisms of this pathology.

Keywords: necrotizing fasciitis, colorectal cancer, postoperative complication.

DOI: 10.7176/ALST/96-01

Publication date: December 31^st 2022