Neglected Abdominal Wound Complicated by Necrotizing Fasciitis of the Pelvic Region: Case Report

Penetrating abdominal injuries (PAIs) often lead to severe complications, including necrotizing soft tissue infections (NSTIs) such as Fournier’s gangrene, which typically involve the perineum and genitalia. However, NSTIs may also present atypically, involving the abdominal wall, flank, and lower extremities, particularly when complicated by bowel perforations. This article examines a case of a 47-year-old male who developed NSTIs following a stab wound to the left flank, with subsequent peritonitis, abscess formation, and necrotizing infections extending to the scrotum and pelvis. Despite aggressive surgical management, including Hartmann’s procedure and extensive debridement, the patient succumbed to septic and hemodynamic shock. This case underscores the importance of early detection and intervention for NSTIs in the context of abdominal trauma and the need for timely surgical exploration, debridement, and appropriate antimicrobial therapy to improve survival rates. This paper further explores the pathogenesis, clinical presentation, and management strategies for NSTIs resulting from bowel perforation in abdominal trauma, aiming to enhance early diagnosis and reduce mortality.