{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:12:48Z","timestamp":1781525568482,"version":"3.54.1"},"reference-count":32,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,25]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Necrotising fasciitis (NF) is a rare surgical emergency characterised by soft tissue necrosis and systemic compromise. Typically it originates following adjacent skin and soft tissue insult; however, our unusual case required a high index of clinical suspicion to avert potential mortality. A man in his 60s with diabetes mellitus presented with 2\u2009weeks of knee pain, swelling and necrotic skin on the posterior calf. X-ray demonstrated subcutaneous emphysema. Initial debridement confirmed extensive necrotising fasciitis of the whole lower limb with tracking through femoral canal into the abdomen. CT confirmed sigmoid colon perforation. Both life-saving Hartmann\u2019s and hip disarticulation procedures were performed with good outcomes. Histology confirmed locally invasive sigmoid colon adenocarcinoma. Our case highlights lower limb necrotising fasciitis as a rare complication secondary to sigmoid perforation associated with malignancy. In cases where the infection nidus cannot be identified, an abdominal source should be considered.<\/jats:p>","DOI":"10.1136\/bcr-2024-262470","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T10:01:33Z","timestamp":1734516093000},"page":"e262470","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Lower limb necrotising fasciitis descending from malignant colonic perforation: a rare pattern"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5455-6763","authenticated-orcid":false,"given":"Elliot","family":"Robbie","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Lewisham and Greenwich NHS Trust, London, UK"},{"name":"Trauma and Orthopaedics, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, 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