The squelching hip: a sign of life-threatening sepsis following haemorrhoidectomy

Abstract

We report a case of fulminating infection tracking from the left ischiorectal fossa to the popliteal fossa as a consequence of rectal perforation 11 days following traditional Milligan–Morgan haemorrhoidectomy. The case presented as a loud squelching noise coming from the hip on walking. Extensive cellulitis was evident over the posterior aspect of the thigh, with a deep fluctuant collection in the left buttock that communicated with the posterior compartment of the thigh. Per rectal examination revealed a defect in the rectal wall, with a foul-smelling discharge. Extensive thigh incision and drainage, defunctioning colostomy, multiple washouts, and split skin grafting procedures were performed. The patient has now recovered.