Necrotizing fasciitis of the lower extremity secondary to a perforated rectosigmoid tumor

Rectogluteal fistula presenting as necrotising myofasciitis of the gluteal region

“…Their presentation is often non-specific with symptoms including hip pain, sciatic nerve palsies, cellulitis or abdominal pain 6 7. In this case, timely identification of subcutaneous emphysema on plain radiographs appropriately prompted a diagnosis of potential necrotising myofasciitis and early intervention with washout and debridement 3 5 7. Aggressive control of infection through means such as antimicrobial therapy and surgical washout has been shown to greatly improve patient outcomes 7…”

“…We present the case of a rectogluteal fistula as a late complication of rectal cancer treatment presenting initially as necrotising myofasciitis. Colonic fistulae to the lower limb have been described in a small number of case reports 1–7. These fistulae reportedly arise as complications of diverticulitis, inflammatory bowel disease, total hip arthroplasty or hip arthrodesis 1–7.…”

“…Colonic fistulae to the lower limb have been described in a small number of case reports 1–7. These fistulae reportedly arise as complications of diverticulitis, inflammatory bowel disease, total hip arthroplasty or hip arthrodesis 1–7. Risk factors associated with enterocutaneous fistulation of a native hip include pelvic radiation for malignancy, diverticulitis, Crohn’s disease and steroid use 1.…”

“…Risk factors associated with enterocutaneous fistulation of a native hip include pelvic radiation for malignancy, diverticulitis, Crohn’s disease and steroid use 1. Several routes of communication between the abdomen and lower limb have been proposed, including the obturator foramen, greater sciatic notch, inguinal or femoral rings, along the femoral vessels, psoas muscles or the femoral sheath 2 3. Few isolated cases of rectogluteal fistulae to a native hip have been reported in the context of previous pelvic radiation treatment 4 5…”

Lower extremity necrotizing fasciitis with iliopsoas abscess secondary to perforated colon cancer: a diagnosis not to miss

“…In cases of NF, the typical clinical presentation includes a patient’s reported history of pain, swelling, and fever, along with noticeable tenderness and redness at the affected site during a physical examination [ 1 , 6 ]. NF on the lower extremities or abdominal wall without an obvious cutaneous source, an intra-abdominal cause should be considered [ 9 ]; surprisingly, only 16% of NF cases are caused by a perforated gastrointestinal tract secondary to malignancy [ 5 ]. The prevalence of perforated CC is between 3% and 10% [ 10 ], and the development of an intra-abdominal abscess is exceedingly rare, occurring in only 0.3%–0.4% of cases [ 11 ].…”