IntroductionNecrotizing fasciitis is a severe inflammatory disease of the body's soft tissue characterized by spreading rapidly and high mortality. Rapid surgical intervention along with other supportive measures of treatment have a great impact on the outcome of treatment. Material and methodsThis study was conducted by a retrospective medical record review of all patients with a microbiologically and clinically confirmed diagnosis of necrotizing fasciitis who were admitted to the general surgery department at the General Hospital Novi Pazar, Serbia, during the period between 2017 and 2020. Demographic, clinical, laboratory, and microbiology data were analyzed. ResultsA total of 13 cases were identified, which represents 0.21% of the total number of patients treated at the surgical department during the period January 2017 to November 2020. The mean age of patients was 55 years, with a male/female ratio of 1:1.6. All of them had at least one comorbidity and more than half had three or more. Diabetes, cardiovascular diseases, and obesity were the most common comorbidities. The most common causes of infection were Klebsiella spp, Pseudomonas aeruginosa, S. pyogenes, and S. aureus. All patients received multiple surgical interventions (mean 2.3). ConclusionTreating necrotizing fasciitis requires a multidisciplinary approach. Early diagnosis and rapid clinical response allow for better disease outcomes. Getting to know more about necrotizing fasciitis will help doctors make better decisions when treating it.
Introduction. Since the announcement of the SARS-CoV-2 pandemic, the health system has been facing great challenges. Due to several uncertainties and concerns, surgeons face a huge challenge in solving urgent surgical conditions in order to save a life. Case report. We present a patient with a coronavirus (COVID-19) infection and acute abdomen who was in poor general condition at the time of surgery, septic, all as a result of duodenal ulcer perforation. She did not have a positive RT-PCR at the time of surgery, but the lung CT scan showed highly indicative signs of COVID-19 infection. She had a positive nasopharyngeal swab RT-PCR test for the SARS-CoV-2 virus on the first postoperative day. Conclusion. All suspected COVID-19 patients during surgery should be treated as positive for SARS-CoV-2 virus with the use of all staff protection measures.
Necrotising fasciitis is a rare and severe disease, acute infection, often life-threatening, characterised by rapid and progressive spread through the subcutaneous tissue and superficial fascia. It can occur on any part of the body, mostly affecting the perineum, limbs and abdominal wall. A 76-year-old male patient with the development of lower limb necrotising fasciitis after a vascular procedure femoral-popliteal bypass, performed due to chronic ischaemia is presented. Patient previously had several different vascular procedures on other blood vessels, with diabetes and cardiovascular disease as leading comorbidities. Treatment included urgent surgical necrotomy, with all measures of conservative treatment. During the treatment, there was no need for a new vascular procedure, arterial flow was preserved. It is necessary to constantly remind surgeons about this rare but life-threatening disease so that they can recognise it in time and adequately treat it.
COVID-19 is an unpredictable disease that can lead to multiorgan dysfunctions. There is a high frequency of venous and arterial thrombosis, among other symptoms,. Spontaneous bleeding in COVID-19 patients has also been described, but rarely, whether or not they are on anticoagulant therapy. We report a case of a 65-year-old female COVID-19 patient treated in our hospital. During the hospitalisation, she experienced sudden, severe pain in the lower part of the abdomen and had signs of hemorrhagic shock. CT of the abdomen and pelvis revealed a spontaneous giant haematoma of the anterior abdominal wall. A surgical procedure was done. We identified spontaneous bleeding in the muscles of the anterior abdominal wall. The patient recovered well. Rapid diagnosis and timely intervention are crucial to ensure a good patient outcome.
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