Acute lower abdominal infections presenting as necrotizing soft tissue infection of the thigh: A report of 3 cases

Necrotizing soft tissue infection is an orthopedic surgical emergency. Early diagnosis is often difficult due to the non-specific symptoms and signs and the rapid progression. Herein, we report three cases who had abdominal infections but presented with lower limbs severe soft tissue infections as the initial presentation. The diagnoses included acute appendicitis, diverticulitis, and ruptured colon cancer, which spread to the retroperitoneal space causing necrotizing soft tissue infection of the lower extremities without abdominal symptoms and signs. Necrotizing soft tissue infection of the thigh should raise suspicion of severe abdominal infections. These conditions may be life threatening, and an early diagnosis and aggressive surgical debridement are essential to improve survival.