scholarly journals EARLY DIAGNOSIS AND PROMPT SURGICAL EXCISION WITH COMPLETE DIVERTING COLOSTOMY: IMPROVE THE OUTCOME IN PATIENTS WITH FOURNIER’S GANGRENE.

2006 ◽  
Vol 12 (1) ◽  
pp. 82-86
Author(s):  
Jasim D Saud ◽  
Noori H Jasim ◽  
Majid A Mohammed
Keyword(s):  
Early Diagnosis ◽  
Surgical Excision ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Diverting Colostomy

Fournier's Gangrene of Genitalia: Case Report

2003 ◽  
Vol 70 (1-4) ◽  
pp. 38-40
Author(s):  
P. Salciccia ◽  
G. Poveromo ◽  
S. Salciccia
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Early Diagnosis ◽  
Rare Disease ◽  
Abdominal Wall ◽  
Sudden Onset ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Prodromal Symptoms

Fournier's gsngrene is a rare disease involving the scrotum and the penis with occasional extension up to the abdominal wall. The etiology of the disease, commonly without prodromal symptoms and with sudden onset, is still not fully understood. The organisms are usually streptococcus haemoliticus and/or anerobic bacteria. We report a case of Fournier's gangrene, presenting septic shock. The patient was treated with reanimatory care, antibiotics, local excision and debridment. Speaking about anatomical and etiopathogenetic hypotheses, we discuss the diagnostic problems and the treatment of the disease. We emphasize the role of the early diagnosis.

scholarly journals Treatment of Complete Anal Stricture after Diverting Colostomy for Fournier’s Gangrene

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Kenji Okumura ◽  
Tadao Kubota ◽  
Kazuhiro Nishida ◽  
Alan Kawarai Lefor ◽  
Ken Mizokami
Keyword(s):  
Soft Tissues ◽  
Fournier’S Gangrene ◽  
Colostomy Closure ◽  
Anal Stenosis ◽  
Fournier's Gangrene ◽  
Anal Stricture ◽  
Internal Hemorrhoids ◽  
Old Japanese ◽  
History Of ◽  
Diverting Colostomy

Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier’s gangrene and treated with debridement and diverting colostomy. He needed temporary continuous renal replacement therapy and was discharged on postoperative day 39. After four months, severe anal stenosis was found on physical examination, and total colonoscopy showed a complete anal stricture. The patient was brought to the operating room and underwent colostomy closure and anoplasty. He recovered without any complications. Conclusion. We present a first patient with a complete anal stricture after diverting colostomy treated with anoplasty and stoma closure. This case reminds us of the assessment of distal bowel conduit and might suggest that anoplasty might be considered in the success of the colostomy closure.

scholarly journals Fournier’s Gangrene: the Criteria for Diagnosis, Prognostic Factors, Complications and Mortality

2017 ◽  
Vol 10 (2) ◽  
pp. 154-164
Author(s):  
Andrew Vladimirovich Prokhorov
Keyword(s):  
Early Diagnosis ◽  
Soft Tissues ◽  
Laboratory Data ◽  
Scoring Systems ◽  
Fournier’S Gangrene ◽  
Systematic Evaluation ◽  
Fournier's Gangrene ◽  
Early Stages ◽  
Prognostic Criteria ◽  
Complications And Mortality

The early diagnosis, prognosis, complications and mortality Fournier’s gangrene (FG) are discussed. The terms pre-hospital period with FG is amount of 8.0 ± 5.2 days. Cases of misdiagnosis are observed in 70% in the early stages of FG due to nonspecific clinical and laboratory picture, lack of awareness and alertness of doctors. Early diagnosis of FG is based on clinical and laboratory data of the picture. In order to timely diagnosis of FG is used scale laboratory indicators of necrotizing fasciitis (LRINEC), allowing suspect FG in doubtful cases. In diagnostically unclear cases FG used radiation methods. At the slightest suspicion on the FG made explorative operation, including express biopsy of soft tissues. The differential diagnosis is carried out in the early stages of FG with acute diseases anogenital region and is rarely used. As a prognostic criteria discussed the patient's age, the presence and nature of comorbid diseases, severity of the condition, the hospital admission dates, duration of preoperative period, necrosis area, metabolic parameters, the amount of remedial necrectomy, antibiotic regimen, hyperbaric oxygen therapy. For the systematic evaluation of the severity of the patient's condition and prognosis use different scoring systems. Many of the proposed prognostic criteria are controversial. The favorable prognosis in FG is entirely dependent on early diagnosis and timing of emergency surgery. Sepsis and its complications are the main causes of deaths. Mortality in the FG has been a steady downward trend, and is 22.3 ± 8.8%. Prevention of the FG is a timely treatment of infectious and inflammatory diseases of the urinary organs and their complications.

Fournier’s gangrene - challenge for surgeon

2019 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Jakub Kuchinka ◽  
Jarosław Matykiewicz ◽  
Iwona Wawrzycka ◽  
Marta Kot ◽  
Włodzimierz Karcz ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Bacterial Flora ◽  
Surgical Excision ◽  
Fournier’S Gangrene ◽  
Diagnostic Tools ◽  
Malignant Neoplasms ◽  
Fournier's Gangrene ◽  
Clinical Issue ◽  
Fournier Gangrene ◽  
The Moment

Introduction. Fournier gangrene (FG) is life - threatening condition, defined as the necrotizing fascitis of perineum and can spread to the adjacent areas. It is rare disease and infection is caused by mixed bacterial flora, seldom by fungal infection. Risk factors are: male sex, diabetes, hypertension, malignant neoplasms, alcoholism, immunospression. Material and methods. The analysis of four group patients treateted for Fournier gangrene was made about diagnostic and therapeutic process, assessment of prognosis based on Fournier’s Gangrene Severity Index). Results. All patients were males. Average age at the moment of diagnosis was 60 years. All of them had comorbidities resulting with the higher risk of susceptibility to FG. Morbitity was 50%, despite of all of patients had less than 9 points in FGSI. Discussion. The FG, despite of better diagnostic tools and technological progres remaines the significant clinical issue because of the mortality - 80%. „The golden standard” is surgical excision of necrotic tissues, antibiotics support, equation of fluid, electrolytes and base – acid balance, level of glycemia is very important. The treating results were assessed on the base of FGSI. The significance has the moment of performing the surgical intervention – it is proven, that should be carried out during 24 hours. The hyperbaric oxygen therapy is controversial. Seem to be appropriate if the infection is caused by anaerobic bacteria. Conclusions. Fournier syndrome is significant clinical issue. Its treatment requires early surgical approach with exicision of necrotic tissues, antibiotics support and treatment of hyperbaric oxygen in some cases.

scholarly journals Fournier’s Gangrene of the Shoulder Girdle

2020 ◽  
Author(s):  
Gyoguevara Patriota ◽  
Luiz Marcelo Bastos Leite ◽  
Nivaldo Cardozo Filho ◽  
Paulo Santoro Belangero ◽  
Benno Ejnisman
Keyword(s):  
Early Diagnosis ◽  
High Mortality ◽  
Human Body ◽  
Surgical Intervention ◽  
Subcutaneous Tissue ◽  
Shoulder Girdle ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Progressive Necrosis

Fournier’s gangrene is uncommon, a high-mortality infection that affects the subcutaneous tissue with rapidly progressive necrosis. Reports on cases involving the shoulder girdle are more rare. Similar to the presentation on other regions of the human body, fundamental is early diagnosis and surgical intervention.

Fournier's gangrene as Amyand's hernia complication

2019 ◽  
Vol 98 (7) ◽  
pp. 291-296
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Rare Condition ◽  
Sporadic Case ◽  
Fournier’S Gangrene ◽  
Amyand’S Hernia ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Based Medicine ◽  
Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

Fournier’s gangrene due to Salmonella Typhimurium in a healthy male: a rare aberrant infection

2020 ◽  
Vol 20 ◽  
Author(s):  
Varsha Gupta ◽  
Lipika Singhal ◽  
Kritika Pal ◽  
Mani Bhushan ◽  
Rajeev Sharma ◽  
...  
Keyword(s):  
Salmonella Typhimurium ◽  
Systemic Disease ◽  
External Genitalia ◽  
Fournier’S Gangrene ◽  
The Body ◽  
Healthy Male ◽  
Fournier's Gangrene ◽  
Salmonella Infections ◽  
Chief Complaints ◽  
Human Infections

Introduction: Human Salmonella infections have been classically distinguised into diseases caused by typhoidal and non-typhoidal salmonella (NTS). Typhiodal salmonella includes S. enterica serovars Typhi and Paratyphi that cause the systemic disease but are restricted to human infections, while NTS consists mainly of other serovars that predominantly cause self-limiting gastroenteritis in humans. Localisation of foci with persisting infection occurs due to dissemination of the bacteria throughout the body and can cause a variety of rare clinical syndromes at aberrant sites. Fournier’s gangrene, a rapidly progressive, often fatal, necrotizing fasciitis of the external genitalia and perineum due to Salmonella Typhimurium, is a rare manifestation and has never been reported. Case: A 22-year-old male, apparently healthy patient with no relevant past medical history presented to surgical emergency with chief complaints of swelling of bilateral scrotal area. Infective etiology was considered and a diagnosis of fournier’s gangrene was made. Pure growth of Salmonella Typhimurium was obtained after repeated subculture and was identified biochemically and on serotyping, as Salmonella enterica serotype Typhimurium using specific antisera. Conclusion: In our case report, we describe a case of fournier’s gangrene due to Salmonella Typhimurium in an otherwise healthy male to highlight the unusual presentation of Non typhoidal salmonellae at an aberrant site. We also emphasize the importance of using selective media like Selenite F broth for isolation of Salmonella Typhimurium from a pus sample.

Gangrena de Fournier. Reporte de caso

2020 ◽  
Vol 63 (5) ◽  
pp. 26-30
Author(s):  
Paloma Pérez Ladrón de Guevara ◽  
Georgina Cornelio Rodríguez ◽  
Oscar Quiroz Castro
Keyword(s):  
Mortality Rate ◽  
Necrotizing Fasciitis ◽  
Broad Spectrum ◽  
Soft Tissues ◽  
Fournier’S Gangrene ◽  
Type Ii ◽  
Necrotic Tissue ◽  
Fournier's Gangrene ◽  
Necrotizing Fascitis ◽  
Key Words Fournier's Gangrene

Fournier’s Gangrene is a type II necrotizing fascitis that leads to thrombosis of small subcutaneous vessels and spreads through the perianal and genital regions and the skin of the perineal. Most cases have a perianal or colorectal focus and in a smaller proportion it originates from the urogenital tract. The mortality rate varies between 7.8 and 50%1-3, only timely diagnosis decreases the morbidity and mortality of this condition. Treatment includes surgical debridement of all necrotic tissue and the use of broad-spectrum antibiotics. Key words: Fournier’s gangrene; gangrene; necrotizing fasciitis; infectious necrotizing of soft tissues.

scholarly journals Algorithm of rational approach to reconstruction in Fournier’s disease

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1028-1037
Author(s):  
Domenico Tripodi ◽  
Maria Ida Amabile ◽  
Federica Gagliardi ◽  
Federico Frusone ◽  
Marzia Varanese ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Fournier’S Gangrene ◽  
Rational Approach ◽  
Skin Grafts ◽  
Local Infection ◽  
Fournier's Gangrene ◽  
Rare Form ◽  
Perineal Region ◽  
Reconstructive Technique ◽  
Diabetes And Obesity

Abstract Background Fournier’s gangrene is a rare form of necrotizing fasciitis that affects the genital area up to the perineal region and sometimes the abdominal wall. Objectives Our article aims to show that in the treatment of extensive forms of Fournier’s gangrene, correct use of flap and skin grafts and a quick reconstruction of the exposed tissues avoid scarring retraction of the testicles and deformation of the penis. Materials and methods We retrospectively reviewed the clinical and photographic data of Fournier’s gangrene cases treated at our Institute. The data were evaluated to obtain an estimate of the results of the reconstructive technique used, in terms of percentage of occurred healings and eventual complications. Results A total of 34 patients underwent surgery for Fournier’s gangrene. In nine cases (26.5%), we had minor complications: in four patients, suffering from diabetes and obesity, a retard in attachment of graft occurred, while in five patients with perianal problems there was a delay in healing due to the onset of local infection. Conclusion The reconstruction approach described here may reduce surgical times. In Fournier’s gangrene, the exposed tissues must be reconstructed as quickly as possible.

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