Abstract
Necrotizing fasciitis is a soft tissue infection characterized by rapid progression caused by gas-forming organisms. Retroperitoneal necrotizing fasciitis is a rare and fatal condition posing a diagnostic and management challenge. We present a case of a 28-year-old man who presented to the emergency department with a two-day history of diarrhea, right lower quadrant abdominal pain, dysuria, and a history of tender perianal swelling. A CT scan of the abdomen and pelvis showed extensive emphysema involving abdominopelvic retroperitoneal spaces. The patient underwent incision and drainage of the perianal area initially followed by diagnostic laparoscopy and drainage of retroperitoneal space. Early detection and extensive debridement of devitalized tissue are the cornerstones of the successful management of necrotizing fasciitis. This is the first case to report laparoscopic management of retroperitoneal necrotizing fasciitis.