Thigh Necrotizing Fasciitis Secondary to Perforated Sigmoid Diverticulitis

A 92-year-old woman was brought to the emergency room due to confusion over the previous 4 days. The examination revealed diffuse abdominal pain, without peritonism, together with subcutaneous emphysema on the left thigh. The blood panel demonstrated marked leukocytosis (46 × 10³/μL) together with acute kidney failure and hyperkalemia. Computed tomography showed acute diverticulitis with a pelvic abscess (Fig. 1A arrowhead), fistulized to the left thigh, causing necrotizing fasciitis in that area (Fig. 1B). The patient died in the hours following her admission as a result of septic shock.

Figure 1