Abstract
An 88-year-old woman was admitted to our hospital because of worsening lower abdominal pain. The laboratory findings indicated a severe inflammatory response and abdominal CT scan showed a large amount of gas in the lower anterior abdominal wall. She was immediately given a broad spectrum antibiotic and underwent drainage. Because her condition did not improve, debridement under spinal anesthesia was performed. Extensive necrosis, affecting both fascial planes and subcutaneous tissue, was observed. There was a depression in the right lower abdominal wall. Many weeks later, a CT fistulogram showed fistula formation between the intestinal tract and the right lower abdominal wall. Laparotomy was performed. The fistula had formed between the appendix and right lower abdominal wall. An appendectomy was performed and the fistula was sutured. There have been 6 reported cases of necrotizing fasciitis (NF) caused by acute appendicitis in Japan. We thus report our experience with this rare case with NF caused by acute appendicitis.
