A rare and fatal cause of right iliac fossa pain - when retroperitoneal necrotizing fasciitis masquerades as acute appendicitis: A case report and review of recent reported cases

Introduction: Retroperitoneal necrotizing fasciitis is an uncommon, rapidly fatal condition which often mimics other diseases. Case presentation: We report a case of an elderly woman who was referred to our Emergency Department for suspected acute appendicitis. Computed tomography scan showed an ili...

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Bibliographic Details
Published in:Hong Kong journal of emergency medicine 2018-11, Vol.25 (6), p.366-370
Main Authors: Chan, Jing Jing, Sheth, Sujata Kirtikant
Format: Article
Language:English
Subjects:
Appendicitis
Case reports
Emergency medical services
iliopsoas abscess
Iliopsoas muscle
Management
Necrotizing fasciitis
Retroperitoneal fibrosis
Retroperitoneal necrotizing fasciitis
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Summary:Introduction: Retroperitoneal necrotizing fasciitis is an uncommon, rapidly fatal condition which often mimics other diseases. Case presentation: We report a case of an elderly woman who was referred to our Emergency Department for suspected acute appendicitis. Computed tomography scan showed an iliopsoas abscess with necrotizing fasciitis on computed tomography scan. Despite aggressive surgical treatment and early antibiotics, she passed away 3 weeks later. Conclusion: Such a case has rarely been reported in an immunocompetent patient who has had no instrumentation, surgeries, or trauma. It serves to highlight the difficulty in diagnosing retroperitoneal necrotizing fasciitis, especially in the elderly patient, as well as the need to recognize it early in the Emergency Department.
ISSN:1024-9079
2309-5407
DOI:10.1177/1024907918755176