Published: 2020-01-27

A rare case of colonic perforation presenting as Fournier’s gangrene

Haraesh Maranna, Pawan Lal, Lovenish Bains, Salil Yadav, Rahul Bhatia, M. Yasir Beg, Pritesh Kumar, Eva Wilse Momin, Gaurav Kumar


A 48-year-old obese gentleman with mild pain over abdomen for 10 days followed by pain and swelling in the right side of scrotum with skin discolouration for 2 days. Clinically necrotic patch with pus discharge was noted on the right side of scrotum. Extensive debridement over scrotum was done following which inflamed omentum and fecal contents were noticed from the inguinal canal. Patient underwent laparotomy and an ascending colonic perforation was found. A loop colostomy with partial omentectomy and inguinal hernia repair along with serial debridement of scrotal wound was done. Although uncommon, gastrointestinal perforations should be considered as a potential etiology in Fournier’s gangrene.


Fournier gangrene, Inguinal hernia, Perforation, Peritonitis

Full Text:



Smith GL, Bunker CB, Dinneen MD. Fournier's gangrene. BJU Int. 1998;81(3):347-55.

Laucks S. Fournier’s Gangrene. Surg Clin North Am. 1994;74(6):1339-52.

Sorensen M, Krieger J, Rivara F, Broghammer J, Klein M, Mack C, et al. Fournier's Gangrene: Population Based Epidemiology and Outcomes. J Urol. 2009;181(5):2120-6.

Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, et al. Fournier's gangrene and its emergency management. Postgrad Med J. 2006;82(970):516-9.

Tenório C, Lima S, Albuquerque A, Cavalcanti M, Teles F. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI). Int Braz J Urol. 2018;44(1):95-101.

Ossibi P, Souiki T, Majdoub K, Toughrai I, Laalim S, Mazaz K, et al. Fournier gangrene: rare complication of rectal cancer. Pan African Med J. 2015;20.

Papadimitriou G, Koukoulaki M, Vardas K, Grigorakis A, Vougas V, Drakopoulos S. Fournier′s gangrene due to perioperative iatrogenic colon perforation in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2015;26(6):1257.

Gerber G, Guss S, Pielet R. Fournier's gangrene secondary to intra-abdominal processes. Urol. 1994;44(5):779-82.

Dewire D, Bergstein J. Carcinoma of The Sigmoid Colon: An Unusual Cause of Fournier’s Gangrene. J Urol. 1992;147:711-2.

Medina P, González-Rivas F, Blanco Á, Tejido S, Leiva G. 3 Historical review of fournier's gangrene: baurienne, 1764 and herod the great, 4 B.C. Eur Urol Suppl. 2009;8(4):121.

Fournier JA. Gangrene foudroyante de la verge. Semaine Medicale.1883;3:345-8.

Woodring J, Heiser M. Detection of pneumoperitoneum on chest radiographs: comparison of upright lateral and posteroanterior projections. AJR Am J Roentgenol. 1995;165(1):45-7.