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Case Reports
. 2024 Aug 15;16(8):e66958.
doi: 10.7759/cureus.66958. eCollection 2024 Aug.

An Uncommon Consequence of Perforated Acute Appendicitis in Elderly Patients: Fournier's Gangrene

Ali Murtada  1 , Angelika Zielinski  1 , Mohamed Siddig Mohamed  2 , Hussam Khougali Mohamed  3 , Sheik Fazal Ur Rehman  4
Affiliations
Case Reports

An Uncommon Consequence of Perforated Acute Appendicitis in Elderly Patients: Fournier's Gangrene

Ali Murtada et al. Cureus. .

Abstract

Acute appendicitis that is not diagnosed and treated promptly typically results in serious complications that raise the risk of necrotizing fasciitis, particularly in elderly patients. We present a case of a 77-year-old male, who presented to the emergency department with a clinical manifestation of Fournier's gangrene caused by acute perforated appendicitis. The patient had no symptoms or signs of an acute abdomen, and within three days he developed significant unilateral scrotal swelling and skin changes. Our case demonstrates the need to treat Fournier's gangrene as a consequence of an intra-abdominal infectious disease, particularly in elderly comorbid patients with atypical symptoms of acute appendicitis, and highlights the importance of early surgical intervention.

Keywords: acute appendicitis; fournier gangrene; intraabdominal sepsis; necrotizing fasciitis; scrotal collection.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Appearance of perforated acute appendicitis (1), pus tract through the inguinal canal (2), and pus collection in right hemi-scrotum (3).
Figure 2
Figure 2. Pus collection and abscess formation through the inguinal region
Figure 3
Figure 3. The collection tracking from the right inguinal region down to the right hemi-scrotum
Figure 4
Figure 4. The degree of necrosis in the scrotum intraoperatively
See this image and copyright information in PMC

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References

    1. Fournier's gangrene secondary to intra-abdominal processes. Gerber GS, Guss SP, Pielet RW. Urology. 1994;44:779–782. - PubMed
    1. Fournier's gangrene after missed acute perforated appendicitis: a case report. Elahabadi I, Bazmandegan G, Salehi H, Jafari A, Ahmadi J, Kamaib Z. Clin Case Rep. 2021;9:0. - PMC - PubMed
    1. Fournier's gangrene secondary to an acutely inflamed appendix herniating into the deep inguinal ring. Sarmah PB, Khan M, Zilvetti M. J Surg Case Rep. 2015;2015:0. - PMC - PubMed
    1. A case of Fournier's gangrene in a young immunocompetent male patient resulting from a delayed diagnosis of appendicitis. Wanis M, Nafie S, Mellon JK. J Surg Case Rep. 2016;2016:58. - PMC - PubMed
    1. Amyand's hernia with appendicitis masquerading as Fournier's gangrene: a case report and review of the literature. Rajaguru K, Tan Ee Lee D. J Med Case Rep. 2016;10:263. - PMC - PubMed

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