Perforated diverticulitis causing necrotizing fasciitis of the lower limb

A 59-year-old woman with a history of colon diverticulosis, who presented with pain in the groin region and in the left lower limb of two months of evolution. In the first instance, the patient presented with symptoms of sepsis and an erythema was observed in the left lower limb, associated with cel...

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Detalles Bibliográficos
Autores: Aguiriano Casanova, María del Mar, Ponce Villar, Úrsula, Peiró Monzó, Fabián, Montesinos, Carmen, Seguí, Jesús
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:Uruguay
Institución:Sociedad de Cirugía del Uruguay
Repositorio:Revista Cirugía del Uruguay
Idioma:español
OAI Identifier:oai:ojs2.revista.scu.org.uy:article/4918
Acceso en línea:https://revista.scu.org.uy/index.php/cir_urug/article/view/4918
Access Level:acceso abierto
Palabra clave:diverticulitis
tratamiento quirúrgico
enfermedades del colon
drenaje
sigmoide
desbridamiento
surgical treatment
colon diseases
drainage
sigmoid
debridement
Descripción
Sumario:A 59-year-old woman with a history of colon diverticulosis, who presented with pain in the groin region and in the left lower limb of two months of evolution. In the first instance, the patient presented with symptoms of sepsis and an erythema was observed in the left lower limb, associated with cellulitis and subcutaneous crepitus. The CT scan showed an air-fluid collection in the psoas and retroperitoneum that ascends to the abdominal cavity, finding perforated diverticulitis. Surgical treatment was based on drainage of the retroperitoneal collection and sigmoidectomy, followed by fasciotomy, debridement, and washing of the thigh. The perforation of a diverticulum can form an intraperitoneal abscess developing a peritonitis or a retroperitoneal abscess, resulting in a bacterial translocation towards the lower limb, due to the communication existing in the crural ring, generating a necrotizing fasciitis of the limb.