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Trocar-site hernia complicated by necrotizing fasciitis—case report and review of the literature

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Abstract

Only a few reports have been published describing necrotizing soft tissue infection (NSTI) following laparoscopic surgery; none identify trocar-site hernia as an etiologic factor. We present a case report and review of the literature. A 43-year-old previously healthy man underwent uneventful laparoscopic cholecystectomy. An unrecognized strangulated lateral trocar-site hernia resulted in fatal NSTI. A Medline database search (1966–2002) identifies ten detailed reports of NSTIs following laparoscopic surgery. Multiple risk factors were identified in almost all patients. The mortality rate was 20%. Patient survival from NSTI requires early recognition, aggressive surgical intervention, and intensive medical care. NSTI can occur following minimally invasive surgery, and physicians should maintain a high index of suspicion when patients begin to develop postoperative symptoms. Trocar-site hernia arises as another etiologic factor for NSTI in the domain of minimally invasive surgery.

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  1. Department of Surgery M580 Health Sciences Center, University of Missouri-Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212, USA

    J. E. Losanoff, B. W. Richman & J. W. Jones

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  1. J. E. Losanoff
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  2. B. W. Richman
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  3. J. W. Jones
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Correspondence to J. W. Jones.

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Losanoff, J.E., Richman, B.W. & Jones, J.W. Trocar-site hernia complicated by necrotizing fasciitis—case report and review of the literature. Hernia 7, 220–223 (2003). https://doi.org/10.1007/s10029-003-0133-1

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  • DOI: https://doi.org/10.1007/s10029-003-0133-1

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