Necrotizing Fasciitis from a Percutaneous Transhepatic Biliary Drainage Site

Percutaneous transhepatic biliary drainage (PTBD) is the established method of treatment for benign or malignant biliary obstruction. Although relatively safe, the procedure is associated with complications including intraperitoneal bile leak, pancreatitis, cholangitis, biliary peritonitis, and hemorrhage. Extraperitoneal complications are rare. Here, we doc-ument a case in which necrotizing fasciitis developed in the extraperitoneal plane surrounding the transcutaneous drainage site. The patient was managed with PTBD removal, drainage and debridement of necrotic tissues, and intravenous antibiotics.