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Necrotizing fasciitis secondary to carcinoma of the gallbladder with perforation
Author(s) -
Okada Kenichi,
Shatari Tomoo,
Yamamoto Tatsuma,
Sasaki Takahiro,
Suwa Tatsushi,
Furuuchi Takayuki,
Takenaka Yoshifumi,
Hori Masao,
Sakuma Masayoshi
Publication year - 2007
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-006-1185-2
Subject(s) - medicine , fasciitis , gallbladder , perforation , subcutaneous abscess , surgery , abscess , radiology , cholecystectomy , carcinoma , pathology , materials science , punching , metallurgy
We present an unusual case of necrotizing fasciitis in the upper abdominal wall caused by penetrating perforation of the gallbladder. It was manifested as an elastic and reddish abdominal swelling with severe tenderness, but no peritoneal irritation. Computed tomography (CT) demonstrated water density with a slightly elevated CT value and air bubbles in the subcutaneous space. The preoperative diagnosis was subcutaneous abscess with fasciitis. At surgery, necrotizing fasciitis and subcutaneous abscess secondary to penetrating perforation of the gallbladder were revealed. Cholecystectomy and peritoneal irrigation were performed. Although no tumor was evident during surgery, a tumor located close to the perforation site was found just after the operation. Pathological examination revealed gallbladder carcinoma without stones. There have been very few previous reports of necrotizing fasciitis following gallbladder perforation. The presentation, diagnosis, and management of fasciitis, as well as carcinoma of the gallbladder with perforation, are discussed.