Perineal necrotizing soft tissue infection secondary to rectal perforation from a large fish bone -a painful lesion not to be missed

Shriranshini Satheakeerthy; Howard Tang; Yasser Arafat; Dilshan Udayasiri; Justin Mc Yeung

doi:10.1016/j.radcr.2023.03.011

Perineal necrotizing soft tissue infection secondary to rectal perforation from a large fish bone -a painful lesion not to be missed

Radiol Case Rep. 2023 Mar 23;18(5):2011-2013. doi: 10.1016/j.radcr.2023.03.011. eCollection 2023 May.

Authors

Shriranshini Satheakeerthy¹, Howard Tang¹, Yasser Arafat^{2

3}, Dilshan Udayasiri^{2

3}, Justin Mc Yeung^{2

4}

Affiliations

¹ Department of General Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia.
² Department of Colorectal Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia.
³ University of Melbourne, Victoria, Australia.
⁴ Department of Surgery, Western Precinct, University of Melbourne, Victoria, Australia.

Abstract

Necrotizing soft tissue infection caused by a large 70 mm fish bone that led to a single perforation of the rectum is an incredibly rare phenomenon. We report a case of an adult male in his 50s who presented with perianal pain. A prompt computed tomography (CT) scan revealed a foreign body had perforated through the rectum into the retrorectal space with associated gas locules, indicating a necrotizing infection. In addition, our case report explores the principles of wide exploration and debridement, the role of a defunctioning colostomy in perineal wound management, and principles of wound closure in the context of a foreign body causing significant perineal sepsis.

Keywords: Abscess; Cellulitis; Foreign body; General surgery; Necrotizing fasciitis; Perineum.

Publication types

Case Reports