Meleney’s Ulcer; A Rare but Fatal Abdominal Wall Disease Complicating Laparatomy

Abstract

Meleney’s ulcer or post operative synergistic bacterial gangrene is a rare form of abdominal wall gangrene but has well documented clinical entity. It develops following intra abdominal surgery in the immediate vicinity of the surgical wound. It is caused by synergistic interaction between microaerophilic nonhemolytic Streptococcus and haemolytic aerobic staphylococcus aureus. We report development of meleney’s ulcer on the third post operative day in a 79 year old lady admitted to our hospital and the challenges of her care. We wish to share the challenges appreciated in making the diagnosis and the difficulties of management. The diagnosis of post operative synergistic gangrene requires high index of suspicion, while early diagnosis and aggressive management predicts good outcome.