Acute appendicitis complicated by necrotizing fasciitis in a teenager

Necrotizing fasciitis is a rare complication of appendicitis in children and is associated with significant morbidity and mortality. We present the case of a 16-year-old male who presented with perforated appendicitis and subsequently developed necrotizing fasciitis of the abdominal wall and perineum. His seven-week hospital course was notable for 16 trips to the operating room, which culminated in staged, complex abdominal wall repair. Ultimately he was discharged home in good condition. The case is remarkable for the extent of soft tissue damage and complexity of repair precipitated by an uncommon complication of a common pediatric disease.