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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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