A case of Meleney’s abdominal gangrene in Madras Medical College

Rengan, Vinayak; Duraisami, Vinodh; Ravindra, Chetna; Muralidharan, Karthik

doi:10.18203/2349-2902.isj20193117

Cited by 4 publications

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“…Necrotizing soft tissue infection, characterized by extensive destruction of tissues and toxemia culminating in fulminant sepsis, is a known entity caused by anaerobes, gram-negative organisms and coliforms. 4 The presence of various co-morbidities increases the chances of rapid deterioration. Presence of excess subcutaneous fat due to obesity acts as an independent risk factor of wound complication in view of poor vascular supply.…”

Section: Discussionmentioning

confidence: 99%

An unwonted case of Meleney’s like abdominal wall necrotizing soft tissue infection

et al. 2019

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Poly-microbial infection leading to necrotizing soft tissue infection is known to cause fulminant sepsis resulting in significant mortality and morbidity despite aggressive medical and surgical management. We present a case of Meleney’s like synergistic gangrene of abdominal wall culminating in full blown sepsis and death in the background of penetrating injury to the abdomen. Our patient was a 36 year old female, who presented with a penetrating injury to the abdomen due to a road traffic accident resulting in a laceration over the anterior abdominal wall with evisceration of bowel and omentum. After initial resuscitation, patient was immediately taken up for exploration and multiple small bowel perforations were primarily repaired. Postoperatively, she developed severe polymicrobial infection at the laceration site which extended all over the abdomen. She was treated with broad spectrum antibiotics based on culture and sensitivity and serial debridement of necrosis was done. She developed ventral hernia during the course, which was complicated by necrosis of bowel which was managed by resection and anastomosis. Postoperatively, she developed multi-organ dysfunction due to sepsis and succumbed to infection. We imply on the necessity of innovative techniques and multidisciplinary approach for controlling sepsis and compensating the significant soft tissue loss due to widespread necrotizing infection.

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Section: Discussionmentioning

confidence: 99%

An unwonted case of Meleney’s like abdominal wall necrotizing soft tissue infection

et al. 2019

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Meleney’s gangrene managed with a single extensive debridement and resultant defect closure with abdominoplasty technique – a case report

Ahmed,

Maharjan,

Hirachan

2024

Annals of Medicine &Amp; Surgery

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Introduction: Meleney’s gangrene, or progressive bacterial synergistic gangrene, is a life-threatening subcutaneous tissue infection and skin necrosis of the abdomen that is persistent and quickly progressing and has documented cultural characteristics of a symbiotic organism. The nobility of this case lies in the use of the modern technique, abdominoplasty used in closer of the wound post radical debridement for Meleney’s gangrene. This uncommon illness has a high fatality rate and requires immediate diagnosis, aggressive antibiotic treatment, and extensive debridement. Case presentation: We report the case of a 55-year-old female with no known comorbidities, who presented to our center with features of Meleney’s gangrene and pleural effusion. Radical debridement was performed and empirical intravenous antibiotics were administered. The wound was closed using the abdominoplasty approach. Clinical discussion: Meleney’s gangrene should be identified quickly and treated with wide-spectrum antibiotics and rigorous surgical debridement. It is difficult to diagnose the illness early, and skepticism is strong during this process. An increased risk of death may follow a postponed diagnosis of Meleney’s gangrene. A long-term hospital stay can result from extensive debridement. Furthermore, skin transplants may be required to close wounds in certain instances. Conclusion: This case is presented to show how early intervention and radical debridement can improve the outcome in cases of Meleney’s gangrene which is rare and clinically significant. Additionally, this suggests that cosmetic procedure known as abdominoplasty could be a viable option for wound closure.

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An Extensive Anterior Abdominal Wall Meleney’s Gangrene Following Bull Gore Injury

Pandiaraja¹

2021

Amrita Journal of Medicine

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Meleney’s gangrene is a rapidly spreading gangrene of skin, subcutaneous tissue, and fascia. It has the highest mortality approximately 40% and more in immunocompromised and diabetic patients. The initial presentation mimics cellulitis and most of the cases are misdiagnosed. Delayed diagnosis and treatment increase mortality by approximately 100%. Our case is initially diagnosed as bull gore injury and underwent treatment of the same. Later patient developed extensive Meleney’s gangrene of the entire anterior abdominal wall and genitalia. Even with extensive wound debridement with antibiotic coverage fails to save the patient life. Therefore, early diagnosis and prompt surgical debridement in boll gore injury will reduce the chance of developing Meleney’s gangrene.

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A case of Meleney’s abdominal gangrene in Madras Medical College

Cited by 4 publications

References 1 publication

An unwonted case of Meleney’s like abdominal wall necrotizing soft tissue infection

An unwonted case of Meleney’s like abdominal wall necrotizing soft tissue infection

Meleney’s gangrene managed with a single extensive debridement and resultant defect closure with abdominoplasty technique – a case report

An Extensive Anterior Abdominal Wall Meleney’s Gangrene Following Bull Gore Injury

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