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Case Reports
. 2020 Oct 4;13(10):e236503.
doi: 10.1136/bcr-2020-236503.

Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier's gangrene: a case series

Edgardo Solis  1   2 , Yi Liang  3 , Grahame Ctercteko  4 , James Wei Tatt Toh  4
Affiliations
Case Reports

Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier's gangrene: a case series

Edgardo Solis et al. BMJ Case Rep. .

Abstract

Fournier's gangrene (FG) is a rapidly progressing infective necrotising fasciitis of the perianal, perineal and genital region. It is characterised by its aggressive nature and high mortality rates of between 15% and 50%. While it has been commonly found to primarily develop from urological sources, there have been increasing reports of the role of colorectal sources as the underlying aetiology of FG. Presented is a case series of four FG presentations at a single institution during a 12-month period as a result of underlying untreated perianal disease highlighting its dangers in progressing to a deadly infection, advocating for early and aggressive surgical debridement, and the role of adjunct scoring systems, such as Laboratory Risk Indicator for Necrotising Fasciitis, in guiding clinical diagnosis.

Keywords: general surgery; infectious diseases.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT scan (axial view) demonstrating a gas-containing abscess within the left ischiorectal region (red outline).
Figure 2
Figure 2
Necrosis of the scrotum with associated crepitus on examination.
Figure 3
Figure 3
Extensive area of necrosis debrided, with greatest area of necrotising infection around the right ischiorectal space with associated fistulating disease.
Figure 4
Figure 4
Seton in the right ischiorectal space with associated fistulating disease (red circle).
See this image and copyright information in PMC

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References

    1. Chennamsetty A, Khourdaji I, Burks F, et al. . Contemporary diagnosis and management of Fournier's gangrene. Ther Adv Urol 2015;7:203–15. 10.1177/1756287215584740 - DOI - PMC - PubMed
    1. Papaconstantinou I, Yiallourou AI, Dafnios N, et al. . Successful treatment of a severe case of Fournier's gangrene complicating a perianal abscess. Case Rep Med 2011;2011:1–4. 10.1155/2011/702429 - DOI - PMC - PubMed
    1. Baurienne H. Sur une plaie contuse qui s’est terminee par le sphacele de le scrotum. J Med Chir Pharm 1764;20:251–6.
    1. Fournier JA. Gangrene foudroyante de la verge. Medecin Pratique 1883;4:589–97.
    1. Ash L, Hale J. Ct findings of perforated rectal carcinoma presenting as Fournier's gangrene in the emergency department. Emerg Radiol 2005;11:295–7. 10.1007/s10140-005-0417-0 - DOI - PubMed

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