A case of a fulminating necrotizing cellulitis after a laparoscopic adhesiolysis performed for ileal obstructive disease, is presented. During operation, a very little intestinal perforation was caused by an "atraumatic grasper", and intestinal fluid flooded into the peritoneum; the lesion was sutured. A copious peritoneal lavage was performed and the operation ended by positioning a peritoneal drain. The patient was going well, passing flatus on the second postoperative day; on the fourth postoperative day erythematous edema close one of the trocar wound appeared. In spite of an aggressive medical and surgical therapy the infection had a very rapid spreading and the patient died six days later. A literature review is reported and simple intraoperative remedies are proposed.