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<p class="p p-first-last" id="__p2">Necrotizing fasciitis is an uncommon but often fatal disease. Given the various causes of necrotizing fasciitis, we report a case of sigmoid colon perforation caused by a toothpick subsequently resulting in fulminant necrotizing fasciitis of the retroperitoneum and right thigh successfully treated by hemipelvectomy and Hartmann´s procedure.</p>