Severe necrotizing fasciitis of the abdominal wall secondary to colon perforation in a child

We discuss the successful saving of an 18-month-old boy with necrotizing fasciitis of the abdominal wall secondary to colon perforation and peritonitis. The patient underwent emergency surgery with exploratory laparotomy, repeated procedures of debridement, and reconstructive abdominal wall surgery with skin graft. He recovered 6 months after admission. We also address the issue of the closure of large abdominal wall defect and the importance of alimentation in this patient group. We discuss the need to recognize necrotizing fasciitis as a potential complication of intra-abdominal disease, as once necrotizing fasciitis occurs, mortality is more likely. We conclude that recognition and aggressive surgical debridement is mandatory.