Abstract
Diverticulosis of the colon is a common condition of increasing age. Complications of diverticulitis including stricture, perforation and fistula formation often require surgery. Perforated diverticulitis may rarely present with spreading superficial sepsis. We describe for the first time, to our knowledge, a case of retroperitoneal diverticula perforation presenting as necrotising fasciitis of the leg necessitating hind-quarter amputation.
Highlights
Colonic diverticulosis is a common condition in the Western World and its incidence increases with advancing age [1]
Intra-abdominal sepsis may rarely present as soft tissue infection of the thigh and this has been documented as a complication of appendicitis [5]
An urgent CT of the abdomen, pelvis and legs showed a grossly enlarged left thigh with gas in all muscle compartments (Fig. 1). He was demonstrated to have gas in the gluteal muscles and gas extending along the left psoas muscle into the retroperitoneum (Fig. 2)
Summary
Colonic diverticulosis is a common condition in the Western World and its incidence increases with advancing age [1]. Perforation as a result of infected diverticulitis often leads to intra-abdominal sepsis and peritonitis requiring emergency surgery [2]. Diverticulitis perforates into the anterior abdominal wall or retroperitoneum causing spreading infection that may require massive debridement [3,4]. Intra-abdominal sepsis may rarely present as soft tissue infection of the thigh and this has been documented as a complication of appendicitis [5].
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