Tissue-Conserving, yet Radical Surgery for Extensive Gas-Forming Soft Tissue Infections Arising from Perirectal Abscess: Report of a Case

Background: Perirectal abscess is encountered commonly in surgical practice, and simple incision and drainage usually is sufficient. However, life-threatening sepsis may occur. In such instances, the high morbidity and mortality rates from the severe systemic inflammatory response syndrome (SIRS) associated with rapidly evolving necrotizing and gas-forming soft tissue infections are of major concern. Methods: Case report and review of pertinent literature. Results: A rare case of extensive necrotizing fasciitis of the torso arising from a perirectal abscess, in which the principles of radical surgical debridement were adhered to while minimizing disfigurement, is reported in a 19-year-old female. In some cases, despite the life-threatening nature of necrotizing fasciitis, it is possible to minimize tissue loss without compromising patient survival. Conclusion: Planning of the patient's site rehabilitation for maximum cosmetic outcome commences at the time of surgical debridement and is especially important for the young patient.