Right thigh necrotizing fasciitis induced by perforated appendicitis

ABSTRACT

Acute appendicitis is one of the most common surgical diseases. However, diagnosis is often delayed due to atypical manifestations of appendicitis. Delayed diagnosis causes complications such as perforation, wound infection, abscess, and peritonitis. Necrotizing fasciitis (NF) complicated by perforated appendicitis is extremely rare and can be fatal. Herein, we report the case of an elderly woman presenting with NF of the right leg due to hidden perforated appendicitis. She had multiple medical diseases and initially complained of right leg pain for 3 days without any abdominal symptoms or signs. Her vital signs became unstable on the second day after admission. Computed tomography showed deep NF of the right leg extending from the perforated appendicitis. Emergency surgery was performed after appropriate resuscitation, but she failed to recover from sepsis and died 42 days after surgery.