A rare postoperative complication of perforated appendicitis: necrotizing fasciitis

Perforated appendicitis is a type of acute appendicitis with a morbidity rate of 15.8%. In addition, potentially fatal postoperative complications associated with laparoscopic appendectomy for perforated appendicitis may occur with wound infections comprising 15.2% of such complications. Herein we report a case in which a 35-yearold woman presented with acute appendicitis in the clinic. After failure with conservative treatment, laparoscopic appendectomy was performed. Five days after the operation, the patient developed necrotizing fasciitis which was then treated with surgical debridement. After ten days of conservative treatment with intravenous antibiotics and forty days of modified vacuum sealing drainage, the patient attained full recovery. This case represents a potentially fatal postoperative complication of perforated appendicitis which is especially rare. Retroperitoneal inflammation and/or abscesses may cause necrotizing fasciitis through lumbar triangles, which are two weak areas in the loin. Therefore, modified vacuum sealing drainage is a simple and effective treatment to treat necrotizing fasciitis.