http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//Issues/2008/11/Cases/Lower-limb-necrotizing-fasciitis.aspx<p>A 75-year-old man was admitted after 3 days of fever and left buttock pain. Two years previously, he had undergone low anterior resection followed by adjuvant chemoradiotherapy for stage III adenocarcinoma of the rectum. He was diagnosed to have anastomotic recurrence 14months after the initial surgery. However, he declined further surgery and elected to receive palliative chemotherapy instead. Two weeks prior to the current admission, he developed intestinal obstruction, which necessitated surgical intervention. A loop of the terminal ileum was found adherent to the pelvic tumor, which was inseparable from the pelvic side wall. An ileotransverse bypass and a colostomy were fashioned to alleviate the bowel obstruction. The symptoms of intestinal obstruction resolved after surgery, and he was discharged on postoperative day 8.</p> <p>Upon admission, erythema and swelling was noticed over the left buttock and upper lateral thigh region. The area was extremely tender,and the left hip movement was greatly restricted because of the underlying pain. The abdominal examination was unremarkable and the colostomy was well functioning. The recurrent rectal tumor was evident on digital rectal examination. Blood test showed leukocytosis (14.9 10 ⁹ /L). An urgent computed tomography (CT) of the abdomen and pelvis was performed with administration of oral and intravenous contrast.</p>Wednesday, 05 Nov 2008 19:28:25 GMT