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Case Reports
. 2011 Oct 20:2011:bcr0820114634.
doi: 10.1136/bcr.08.2011.4634.

Septic shock due to Fournier's gangrene of the scrotum

Michael Andrew Callaghan  1 , Richard Baggott, Frank T D'Arcy
Affiliations
Case Reports

Septic shock due to Fournier's gangrene of the scrotum

Michael Andrew Callaghan et al. BMJ Case Rep. .

Abstract

A 57-year-old morbidly obese (160 kg) man presented with a 12 h history of severe bilateral scrotal pain and swelling. His scrotum was erythematous, with cellulitis advancing superiorly along the anterior abdominal wall. He was in septic shock. Following resuscitation with intravenous fluids, commencement of vasopressor infusion and broad-spectrum antimicrobials, he underwent surgical exploration and debridement. This revealed a devitalised gangrenous scrotum with abscess formation noted in the ischio-rectal spaces. This was debrided posteriorly to the wall of the rectum. The penis was de-gloved. Both testicles were spared. A colostomy was performed on day 3 to maintain a clean environment for healing. Subsequent scrotal reconstruction and grafting was performed with a pedicled gracilis flap and split skin grafting. The colostomy was reversed at 5 months.

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Conflict of interest statement

Competing interests None.

Figures

Figure 1
Figure 1
Pre operative images showing swollen, erythematous scrotum.
Figure 2
Figure 2
Black gangrenous patches on right posterior aspect of scrotum.
Figure 3
Figure 3
Post debridement. The penis is de-gloved. The right testes has been placed in the inguinal pouch.
Figure 4
Figure 4
Post scrotal grafting and reconstruction with pedicled gracilis flap and split skin grafts.
See this image and copyright information in PMC

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