Abdominal Wall Necrotizing Fasciitis Secondary to Sigmoid Colon Diverticulitis; A Case Report

Necrotizing fasciitis is a very rare presentation of sigmoid colon diverticulitis. An 80 year-old male presented with an abdominal pain that started 4 days ago and was accompanied by fever¡ chills¡ distention and erythema in the lower quadrants of the abdomen. On examination erythema¡ subcutaneous emphysema and crepitation were present over his lower regions of the abdomen. CT scan revealed sigmoid colon diverticulitis with stranding fat tissue and extended density of free air in the subcutaneous soft tissue of anterior abdominal wall. The patient was started on antibiotics and underwent an aggressive debridement of devitalized tissues. The wound closed by advancement flap with local anesthesia 2 months after surgery and the patient underwent sigmoid colectomy 3 month later. Despite the rarity of such cases¡ gastrointestinal pathologies should always be considered in patients presenting with abdominal wall necrotizing fasciitis.