Fournier’s gangrene is an acute, rapidly progressive, and potentially fatal, infective necrotizing fasciitis affecting the external genitalia, perineal or perianal. Penis and scrotum – Fournier gangrene. First documented in by Professor Jean Alfred Fournier (Whonamedit: Fournier Gangrene. Fournier gangrene is a rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with.
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Fournier Gangrene – NORD (National Organization for Rare Disorders)
They identified several prognostic factors associated with a worse prognosis. Canada Communicable Disease Report. Infection of superficial perineal fascia Colles fascia may spread to the penis and scrotum via Buck and Dartos fascia, or to the anterior abdominal wall via Scarpa fascia, or vice versa. The well vascularized muscle flap demonstrates greater resistance to bacterial inoculums and in wounds with some degree of contamination [ 53 ].
The diagnosis is basically made on clinical findings. Idiopathic gangrene of the scrotum. Treatment and Management The cornerstones of treatment of Fournier’s gangrene are urgent surgical debridement of all necrotic tissue as well as high doses of broad-spectrum antibiotics. Conventional Radiography At radiography, hyperlucencies representing soft tissue gas may be seen in the region overlying the scrotum or perineum. In some series, a mean of four different organisms is cultured from each patient [ 11 ].
Open in a separate window. Fournier’s gangrene extending beyond the pelvic region, add 6.
It is a fasciocutaneous flap based on the terminal branches of the superficial perineal artery, which arises from the internal pudendal artery. Dyspareunia Hypoactive sexual desire disorder Sexual arousal disorder Vaginismus.
The underlying condition was FG in four cases, chronic lymphoedema in two, fourneir deficiency from previous surgeries in two, and Crohn’s disease in one. Fournier gangrene is usually secondary to perirectal or periurethral infections associated with local trauma, operative procedures, or urinary tract disease. Debridement should be stopped when separation of the skin and the subcutaneous is not perform easily, because the cutaneous necrosis is not a good marker.
Electrolytes, BUN, creatinine, blood glucose levels: Anorectal abscesses, urinary tract infections, surgical instrumentation and other contributing factors have all been implicated. Because the infection progresses rapidly, the early stage with lack of subcutaneous emphysema is brief and is rarely seen at CT [ 36 ].
However, necrotic patches soon appear in the overlying skin, which later develop into necrosis. Affected individuals usually have painful swelling of the one epididymitis and the associated testicle. Burn center management of necrotizing soft-tissue surgical infections in unburned patients. ANZ Journal of Surgery.
Fournier’s Gangrene: Current Practices
The mean age of presentation is about 50 years, but the range of patient ages in reported cases is from eight days to 90 years. Author information Article notes Copyright and License information Disclaimer.
Early surgical debridement as shown in Figure 1 of necrotic tissues and gangerna are fundamental in the treatment of FG. Triple antibiotic combined with radical debridement is the mainstay gqngrena treatment.
Infection represents an imbalance between host immunity and the virulence of the causative microorganisms.
Elem B, Ranjan P. These latter microorganisms, in turn, may produce enzymes e. In his large review of patients Eke [ 3 ] suggested that when testicular involvement does occur it indicates a retroperitoneal or intra-abdominal source of infection.
Pathology Outlines – Fournier gangrene
It is usually a consequence of epididymitis see above. Bartholin’s cyst Kraurosis vulvae Vestibular papillomatosis Vulvitis Vulvodynia.
Click here for information on linking to our website or using our content or images. Increased calcium in serum may be due to renal failure, bacteriemia, or use of parenteral nutrition.
La Gangrena de Fournier: Journal of Burn Care and Rehabilitation. In other projects Wikimedia Commons. X-ray studies are useful to confirm the location and extent of gas distribution in the wounds. Initially, FG was defined as an idiopathic entity, but diligent search will show the source of infection in the vast majority of cases, as either perineal and genital skin infections.
Orchitis may be caused by numerous bacterial and viral organisms.