[Pyoderma gangrenosum after TAPP hernioplasty. A rare differential necrotizing wound infection diagnosis]

A rare case of pyoderma gangrenosum occurring at the site of laparoscopic port following laparoscopic radical nephrectomy

Introduction

Pyoderma gangrenosum is a rare dermatological disease associated with underlying inflammatory conditions.

Case presentation

A 59‐year‐old man was diagnosed with right renal cancer cT1aN0M0 and laparoscopic right radical nephrectomy was performed. Five days after surgery, he had a high‐grade fever, surgical site flare, and severe pain. At first, we diagnosed surgical site infection and wound dehiscence. Despite treatment for infection, his general condition and dermatological symptoms did not improve. Thereafter, a dermatologist advised us to perform a skin biopsy and blood culture examinations. Finally, the man was diagnosed with pyoderma gangrenosum according to the pathology of the skin biopsy and negative blood culture. After both intravenous administration of predonisolone and a topical corticosteroid, the high‐grade fever and dermatological symptoms improved greatly.

Conclusion

Although pyoderma gangrenosum is a rare disease, we should bear in mind the disease since the treatment strategy is completely different from that for surgical site infection.

A rare complication following laparoscopic TEP repair: case report and discussion of the literature

Transabdominal pre-peritoneal and totally extra-preperitoneal (TEP) are common laparoscopic techniques used to repair inguinal hernias. With better equipment and techniques for creation of pneumoperitoneum serious complications are now infrequent. However, complications from these techniques that are beyond the control of the surgeon do occur. This report details a rare complication related to infection. It is the first such documented complication of TEP hernia repair. There follows a short literature review of rare complications of laparoscopic hernia repair. Surgeons should familiarize themselves with these potential pitfalls for a number of reasons including, counseling when obtaining consent and heightened awareness for infrequent complications during postoperative follow-up.

[Selected emergencies in operative dermatology]

The large number of surgical procedures in many subspecialty areas of dermatology, such as dermatologic oncology, phlebology and aesthetic dermatology, raises the question of possible complications and emergency situations. Along with common complications such as post-operative bleeding, infections or flap necrosis, there are emergency situations which require immediate intervention to avoid significant harm to the patient. One must distinguish between dermatologic situations which require emergency surgery and emergencies that arise during or after dermatological surgery.