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Abstract: INTRODUCTION: Soft tissue necrotizing infections are a significant cause of morbidity and mortality. The aim of this study is to present a patient with necrotizing infection of abdominal wall resulting from the rupture of a retroperitoneal stromal tumor. PRESENTATION OF CASE: We present a 60-year-old Caucasian male patient with necrotizing infection of abdominal wall secondary to the rupture of a retroperitoneal stromal tumor. The patient was initially treated with debridement and fasciotomy of the anterior abdominal wall. Laparotomy revealed purulent peritonitis caused by infiltration and rupture of the splenic flexure by the tumor. Despite prompt intervention the patient died 19 days later. The isolated microorganism causing the infection was the rarely identified as cause of infections in humans Pediococcus sp., a gram-positive, catalase-negative coccus. DISCUSSION: Necrotizing infections of abdominal wall are usually secondary either to perineal or to intra-abdominal infections. Gastrointestinal stromal cell tumors could be rarely complicated with perforation and abscess formation. In our case, the infiltrated by the extra-gastrointestinal stromal cell tumor ruptured colon was the source of the infection. The pediococci are rarely isolated as the cause of severe septicemia. CONCLUSION: Ruptured retroperitoneal stromal cell tumors are extremely rare cause of necrotizing fasciitis, and before this case, Pediococcus sp. has never been isolated as the responsible agent. [Copyright &y& Elsevier]

Abstract: Background: Prader-Willi syndrome (PWS) is a congenital chromosomal disorder characterized by compulsive hyperphagia and the early development of obesity. Obesity is identified as the main cause of morbidity and mortality in PWS individuals. Thus, body weight reduction is of major importance for a prolonged survival. Patient-Method: A 20-year-old female patient with PWS was referred to our department for surgical treatment of her obesity. At admission, her body weight was 153 kg, and her body mass index (BMI) was 74.33 kg/m2. The patient underwent biliopancreatic diversion with duodenal switch, as well as cholecystectomy and appendicectomy. The volume of the gastric remnant was 100 mL, and the lengths of the gastric and common limbs were 250 and 60 cm, respectively. Results: Eighteen months after the operation, the patient lost 63 kg with no considerable changes in her eating habits. Her sleep disturbances and sleep apnea disappeared, and her social life dramatically improved. Conclusions: Biliopancreatic diversion with duodenal switch seems to be a good method for the treatment of PWS-associated obesity because it offers good results in weight loss without the need for revision, good quality of life, and a chance for a prolonged survival. [Copyright &y& Elsevier]