Publication:

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

A 57 years old male who was a known case of type 2 diabetes presented with a swelling over the left lower abdomen and groin. The patient appeared toxic and local examination revealed discoloration of size 8x6 cm over the groin with a 1×0.5 cm sized ulcer over it accompanied by a seropurulent discharge. A clinical diagnosis of necrotizing fasciitis was made and investigations revealed an elevated blood sugar, white count and creatinine with cultures showing a poly-microbial growth. Emergency debridement under IV sedation was done and subsequently patient underwent daily debridement and dressing in addition to antibiotics and adequate glycemic control. This condition is a surgical emergency and early diagnosis is crucial for improved prognosis. Aggressive surgical debridement is the first line treatment followed by specific antibiotic therapy.