A rare case of postoperative Fournier's gangrene after a hemorrhoidectomy

Authors

  • Mrinalini Alla Department of Surgery, Flushing Hospital Medical Center, Flushing, New York
  • Chloe Bodden Department of Surgery, Flushing Hospital Medical Center, Flushing, New York
  • Patrick Kamere Kiarie St. George’s University, School of Medicine, Grenada, West Indies
  • Noman Khan Department of Surgery, Flushing Hospital Medical Center, Flushing, New York
  • Martine A. Louis Department of Surgery, Flushing Hospital Medical Center, Flushing, New York
  • Neil Mandava Department of Surgery, Flushing Hospital Medical Center, Flushing, New York

DOI:

https://doi.org/10.18203/2349-2902.isj20243245

Keywords:

Hemorrhoid surgery, FG, Necrotizing fasciitis, Postoperative complication

Abstract

Fournier’s gangrene (FG) is a severe and fulminant necrotizing fasciitis of the perineal, genital, and perianal regions. Extensive postoperative infections after anorectal surgeries are rare, and the development of FG after hemorrhoid surgery is extremely rare. We present the case of a 68-year-old diabetic male found to have a severe necrotizing infection of the perianal and perineal region eight days after a hemorrhoidectomy. His hospital course was complicated by septic shock, acute kidney injury, respiratory failure, and multiple strokes. The purpose of this case is to increase awareness of extensive necrotizing infections such as FG, complicating a hemorrhoidectomy, albeit rarely, especially in patients with comorbidities such as diabetes mellitus.

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References

Maria HT, Cheema AS, McGuire MJBS, Janis JE. Practical Review of the Current Management of Fournier’s Gangrene. Plastic Reconstructive Surg Global Open. 2022;10(3):e4191.

Bensardi FZ, Hajri A, Kabura S, Bouali M, El Bakouri A, El Hattabi K, Fadil A. Fournier's gangrene: Seven years of experience in the emergencies service of visceral surgery at Ibn Rochd University Hospital Center. Ann Med Surg. 2021;71(1):10281.

Guldeniz K, Oktay I, Bulent U, Kemal K. Fournier's Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature. Case Rep Gastroenterol. 2009;3:147-55.

Vagholkar K, Deshmukh K, Sai H, Purandare T. Fournier’s gangrene of the scrotum after inguinal hernia repair: Case report. Int Surg J. 2023;10(6):1091-3.

Sroczyński M, Sebastian M, Rudnicki J, Sebastian A, Agrawal AK. A complex approach to the treatment of Fournier’s gangrene. Adv Clin Exp Med. 2013;22(1):131-5.

Sorensen MD, Krieger JN, Rivara FP, Broghammer JA, Klein MB, Mack CD, et al. Fournier's Gangrene: population-based epidemiology and outcomes. J Urol. 2009;181(5):2120-6.

Tarricone A, Mata K, Gee A, Axman W, Buricea C, Mandato MG, et al. A Systematic Review and Meta-Analysis of the Effectiveness of LRINEC Score for Predicting Upper and Lower Extremity Necrotizing Fasciitis. J Foot Ankle Surg. 2022;61(2):384-9.

Erol B, Tuncel A, Tok A, Hanci V, Sari U, Sendogan F, et al. Low magnesium levels an important new prognostic parameter can be overlooked in patients with Fournier's gangrene: a multicentric study. Int Urol Nephrol. 2015;47(12):1939-45.

McCloud JM, Jameson JS, Scott AND. Life-threatening sepsis following treatment for haemorrhoids: a systematic review. Colorectal Dis. 2006;8:748-55.

Dinc T, Kayilioglu SI, Isa S, Baris DY, Faruk C. Fournier’s Gangrene as a Postoperative Complication of Inguinal Hernia Repair. Case Rep Surg. 2014;408217:3.

Subramaniam D, Hureibi K, Zia K, Uheba M. The development of Fournier's gangrene following rubber band ligation of haemorrhoids. BMJ Case Rep. 2013;bcr2013201474.

Bönner C, Prohm P, Störkel S. Fournier-Gangrän als seltene Komplikation nach Staplerhämorrhoidektomie Kasuistik und Literaturübersicht. Chirurg. 2001;72:1464-6.

Giebel GD. Comment on Ch. Bonner et al.: Fournier gangrene as a rare complication after stapler hemorrhoidectomy. Chirurg. 2002;73(3):288.

Kaya C, Bozkurt E, Ömerolu S, Yazici P, Mihmanli M. Fournier’s Gangrene after Hemorrhoidectomy: Case Report and Review of Literature. Gastroenterol Hepatol. 2017;7(2):00238.

Gurfinkel R, Slovik Y, Glezinger R, Walfisch S. Fournier's gangrene as a delayed complication of closed hemorrhoidectomy. Harefuah. 2005;144(6):394-6.

Yang SC, Wu TJ. Fournier's gangrene--Taiwan experience. Zhonghua Yi Xue Za Zhi. 2001;64(4):239-43.

Perkins TA, Bieniek JM, Sumfest JM. Solitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal Etiologies. Rev Urol. 2014;16(2):95-8.

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Published

2024-10-28

How to Cite

Alla, M., Bodden, C., Kiarie, P. K., Khan, N., Louis, M. A., & Mandava, N. (2024). A rare case of postoperative Fournier’s gangrene after a hemorrhoidectomy. International Surgery Journal, 11(11), 1866–1869. https://doi.org/10.18203/2349-2902.isj20243245

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Section

Case Reports