Intraoperative ultrasound facilitates localization in a morbidly obese patient undergoing posterior retroperitoneoscopic adrenalectomy

breast NF is delayed due to preferential infection of Coopers suspensory ligaments. In our case, preoperative imaging was not performed due to the clinical findings of discharging pus. A case report of ultrasound-diagnosed breast NF described deep fluid collection within the breast with bright echoes representing gas. Computed tomography of NF may show interstitial free gas and fat stranding. Magnetic resonance imaging is reported as highly sensitive and low specificity; however, timeliness and haemodynamic parameters often preclude its use in suspected cases of NF. Principles of treatment involve urgent and aggressive surgical debridement, antimicrobial therapy and intensive care support. Hyperbaric therapy is utilized in some settings. Treatment of breast NF often involves radical mastectomy; however, early identification may allow breast conservation. Our case describes a case of breast NF in a young, otherwise healthy female with a recent history of lactational abscess. Our case demonstrates that pain out of proportion to clinical findings may be a clue to NF rather than a simple lactational breast abscess. This case highlights the need for NF of the breast to be a diagnostic consideration and shows that aggressive early debridement can lead to a good clinical outcome.