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 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.

Fournier's gangrene: Report on two cases

1997 ◽  
Vol 64 (2) ◽  
pp. 266-268
Author(s):  
F. Laganà ◽  
E. Cossaro ◽  
C. Ronconi ◽  
F. Sercia ◽  
M. Marchini
Keyword(s):  
Mortality Rate ◽  
Chronic Diseases ◽  
High Mortality ◽  
Hyperbaric Oxygenation ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Tissue Ischemia ◽  
First Choice

– Fournier's gangrene is a rare pathology that generally occurs in weakened patients with chronic diseases, like diabetes, which imply tissue ischemia and even today a high mortality rate. Two cases are presented, one of which is interesting for its pathogenesis. The authors confirm that first choice treatment should be surgical associated with antiobiotics and hyperbaric oxygenation whenever possible.

scholarly journals Anoplasty For Fused Anus Following Fournier’s Gangrene Debridement: A Case Report

2021 ◽  
Author(s):  
Jothinathan Muniandy ◽  
Fitjerald Henry ◽  
Yong Sim Teh
Keyword(s):  
Surgical Intervention ◽  
Learning Experience ◽  
Fournier’S Gangrene ◽  
Anal Stenosis ◽  
Success Rates ◽  
Fournier's Gangrene ◽  
Management Options ◽  
Initial Recovery ◽  
Management Challenge ◽  
Surgical Condition

Abstract Anal stenosis is a rare debilitating surgical condition. The severity and level of the impacted region determines the management options. Numerous tension free anoplasty techniques and its varying success rates have been reported. A patient-tailored anoplasty approach depending on the severity, location, and extent of anal stenosis is rudimentary. We present a case of fused anus following extensive surgical debridement for Fournier’s Gangrene. Colonoscopy illumination guided neo-anal creation was performed, which resulted in low severe anal stenosis six weeks later. Subsequently, Y-V anoplasty, lateral internal sphincterotomy, and colostomy closure were done which showed good initial recovery. However, six months later, the anal stenosis recurred, for which diamond-shaped anoplasty was offered but patient had refused any further surgical intervention. The clinical management challenge and learning experience is shared within the report.

scholarly journals Fournier’s gangrene

2016 ◽  
Vol 97 (2) ◽  
pp. 256-261
Author(s):  
A V Prokhorov
Keyword(s):  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Disease Onset ◽  
Disease Diagnosis ◽  
Fournier’S Gangrene ◽  
Time Interval ◽  
Vacuum Therapy ◽  
Superficial Fascia ◽  
Fournier's Gangrene ◽  
Septic Complications

The review highlights the issues of etiology, pathogenesis, clinical and laboratory picture, radiodiagnosis, treatment and prognosis of fulminant perineum gangrene, or Fournier’s gangrene. According to modern concepts, Fournier’s gangrene is one of the rare forms of necrotizing fasciitis of polymicrobial etiology with a primary lesion of the skin, subcutaneous tissue and superficial fascia of the scrotum, penis, and perineum. Fournier’s gangrene refers to acute surgical diseases of pyonecrotic nature and is characterized by rapid septic course, high mortality, reaching 80%, in spite of the modern antibiotic therapy advances. Over the last decade the Fournier’s gangrene incidence increased in 2.2-6.4 times, due to the increasing number of immunocompromised patients in the population. The disease most often occurs in older men with diabetes, alcoholism and obesity. The Fournier’s gangrene occurrence is preceded by different inflammatory diseases of the colon, urinary organs, scrotum and perineum skin. The disease diagnosis in full-scale stage usually is not difficult. In rare cases, namely in the disease early stages, various radiological methods of investigation, laboratory tests and exploratory surgery with affected soft tissues express biopsy are used with differential diagnosis purposes. The cornerstone in the Fournier’s gangrene treatment is an emergency surgical intervention in combination with a powerful anti-bacterial and anti-shock therapy. To improve the wound healing course and reduce the septic complications risk, new methods of adjuvant treatments such as hyperbaric oxygen therapy and vacuum therapy are used. Hospitalization duration in Fournier’s gangrene is usually lengthy, due to the need to use repeated sanitation necrectomy and reconstructive plastic surgery and are associated with considerable economic costs for treatment. The Fournier’s gangrene prognosis depends on the timing of specialized medical care provision and, above all, on the time interval between the disease onset and surgery performing.

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.

Perianal Infections in Patients With Hematologic Malignancy: The Risk of Fournier’s Gangrene Leading to Mortality and Irreversible Organ Damage

2021 ◽  
Author(s):  
Arife Simsek
Keyword(s):  
Medical Therapy ◽  
Surgical Intervention ◽  
Hematologic Malignancy ◽  
Organ Damage ◽  
Fournier’S Gangrene ◽  
Abscess Formation ◽  
Anal Pain ◽  
Perianal Region ◽  
Fournier's Gangrene ◽  
Diverting Ostomy

Introduction. The efficacy of surgical intervention for perianal infection in patients with hematologic malignancy is not well-established. Objective. This article presents a case series of perianal infection progressing to Fournier’s gangrene (FG) in patients with hematologic malignancy to guide physicians, because to the author’s knowledge, there were no randomized or prospective studies presenting the management strategies reported herein. It was hypothesized that surgery might reduce mortality and morbidity in patients with inflammation spreading beyond the perianal region, in patients with abscess formation, and in those who show no improvement with medical therapy. Materials and Methods. The data of 4 adults with hematologic malignancy who developed perianal infection progressing to FG between January 2010 and December 2018 were reviewed retrospectively. Patients younger than 18 years and patients without hematologic malignancies or FG were excluded. The primary outcome was mortality. The secondary outcome was irreversible organ damage. Results. Four male patients with a mean age of 36.75 years ± 13.1 standard deviation (range, 23–52 years) reported fever and dull anal pain during treatment for hematologic malignancy. A broad-spectrum antibiotic regimen was administered as initial empiric therapy at onset of fever and was de-escalated based on the culture results and clinical response. However, FG arose in all cases approximately 8.75 days ± 6.94 (range, 3–17 days) after onset of anal pain. All patients underwent surgical debridement, and diverting ostomy was performed in 3 cases. One patient died of overwhelming sepsis (25%), and 1 patient required orchiectomy (25%). Conclusions. Clinical suspicion of FG may be effective in reducing mortality in patients with hematologic malignancy, especially in cases with fever accompanied by anal pain. Surgical intervention may improve the prognosis for patients with inflammation spreading beyond the perianal region, patients with abscess formation, those who show no improvement in medical therapy, and those who develop FG. Diverting ostomy may improve survival in patients with FG.

scholarly journals Fournier's Gangrene: A Summary of 10 Years of Clinical Experience

2015 ◽  
Vol 100 (5) ◽  
pp. 934-941 ◽  
Author(s):  
Abdullah Oguz ◽  
Metehan Gümüş ◽  
Ahmet Turkoglu ◽  
Zübeyir Bozdağ ◽  
Burak Veli Ülger ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Length Of Hospital Stay ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fecal Diversion ◽  
Patient Comfort ◽  
Fournier's Gangrene ◽  
Duration Of Treatment ◽  
Progressive Necrosis ◽  
Serious Disease

We aimed to present our clinical experience with FG treatment. Fournier's gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. Patients were divided into 2 groups as survivors and nonsurvivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, FG Severity Index (FGSI) score, fecal diversion methods (trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the nonsurvivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with nonsurvivors (5.00 ± 1.86 and 10.00 ± 1.27, respectively; P < 0.001). We conclude that FGSI is an important predictor in the prognosis of FG. Vacuum-assisted closure (VAC) should be performed in compliant patients in order to enhance patient comfort by reducing pain and the number of dressings. Fecal diversion should be performed as needed, preferably by using FMS. The trephine ostomy should be the method of choice in cases where an ostomy is necessary.

scholarly journals Coexistence of human immuno deficiency virus, diabetes mellitus, epididymal cysts, and Fournier's gangrene: A case report

2021 ◽  
Vol 38 (4) ◽  
pp. 669-671
Author(s):  
Evrim KAR ◽  
Hatice Şeyma AKÇA ◽  
Serdar ÖZDEMİR ◽  
Abdullah ALGIN ◽  
Serkan Emre EROĞLU
Keyword(s):  
Case Report ◽  
Subcutaneous Tissue ◽  
Fournier’S Gangrene ◽  
Clinical Suspicion ◽  
Perianal Region ◽  
Fournier's Gangrene ◽  
Human Immuno Deficiency Virus ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Artery Disease

Fournier's gangrene (FG) is a form of necrotizing fasciitis that is localized in the external genital organs and perianal region and causes skin and subcutaneous tissue gangrene. The clinical picture may vary depending on the patient's comorbidities and the extent of infection; Many predisposing conditions such as immunodeficiency, diabetes, alcoholism encourage the spread of the infection. In this case report, we highlighted the importance of emergency debridement in patients with multiple comorbidities by presenting the Fournier's Gangrene case in a 57-year-old immunosuppressive male patient with cystic lesions in the epididymis, with a history of hypertension, coronary artery disease, diabetes, HIV (human immunodeficiency virus) and a history of bipolar disorder. The patient, who was operated on for debridement by the urology, was given 1x500mg daptomycin, 3x1g meropenem, 3x450mg clindamycin IV treatment. The patient was discharged with full recovery after 17 days of hospitalization. Clinical suspicion in Fournier's gangrene cases, early surgical debridement, and extended-spectrum anti biotherapy are important. with rapid diagnosis and treatment in patients with improvement can also be seen in patients with comorbidities.

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