Abstract
Nonclostridial gas gangrene, the etiology is obscure, is often accompanied by a malignancy in an immunosuppressed patient.
A 71-year-old woman was reffered to our hospital with the symptom of a swelling and a painful dermatitis on the right lower abdomen to the lumber tlunk associated with redness, vesicles and necrosis. A Plain reontgenogram and a computed tomogram revealed gases in the subcutaneous tissue and muscularis, and the debridment was carried out under the tentative diagnosis of the gas gangrene. The bacterial culture revealed the diagosis of a nonclostridial gas gangrene. Then the antimicrobial treatment and the hyper oxygen therapy were done on the patient. Subsequent skin transplantation failed followed by parietoretroperitoneal fistula. Total colonoscopic examination showed no malignancy. As the fistula was resistant to the treatment, laparotomy was performed. At operation, an appendiceal carcinoma with penetraring to retroperitoneum was identified.
Nonclostridial gas gangrene of unknown etiology is often accompanied by some malignancy, especially colonic carcinoma, in immunosuppressed patients. The nonclostridial gas gangrene with Appendiceal carcinomma is rare, and we reported this case with a review of the literature.
