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CASE REPORT
Not your usual hip pain: necrotising fasciitis secondary to sigmoid perforation
  1. Sarthak Soin,
  2. Sumathi Vijaya Rangan,
  3. Faisal Shaukat Ali and
  4. Chukwudumebi Okafor
  1. Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr Sarthak Soin, sarthaksoin{at}gmail.com

Abstract

Necrotising fasciitis (NF) resulting from sigmoid perforation is rare, but none the less remains life threatening. Early surgical intervention and empiric broad-spectrum antibiotic remains the standard of care. A 65-year-old man with history of stage 4 rectal cancer presented with bilateral hip pain. An X-ray of the hip and pelvis to rule out fracture revealed abnormal gas pattern overlying the right hip. CT imaging revealed distal sigmoid perforation with air extending from the pelvis to posterior aspect of the right hip and thigh. Aggressive surgical intervention and antibiotic initiation was associated with successful outcomes in our patient. Although less common, sigmoid perforation leading to NF in posterior thigh is a reminder of a potentially lethal complication.

  • malignant disease and immunosuppression
  • gas/free gas
  • adult intensive care
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Footnotes

  • Contributors SS and SVR contributed equally in writing. FA and CO were involved in reviewing of the manuscript. SS is the article guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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