Extensive fournier gangrene with retroperitoneal involvement in a diabetic patient

Authors

  • M. Sabari Girieasen Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu
  • Naveenkumar Viswanathan Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu
  • S. Nedunchezhian Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu
  • Kannan Ross Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu

DOI:

https://doi.org/10.18203/2349-2902.isj20201894

Keywords:

Extensive fournier gangrene, Necrotising fasciitis, Retroperitoneal involvement

Abstract

Fournier’s gangrene is a rare, rapidly progressive, fulminant form of necrotizing fasciitis of the genital, perianal and perineal regions extending to the abdominal wall between the fascial planes. It is secondary to polymicrobial infection by aerobic and anaerobic bacteria with a synergistic action. A 42 year old male who is an alcoholic and diabetic on irregular treatment presented with scrotal swelling and pain for 5 days following a trauma. On examination, patient was febrile, tachypneic and had tachycardia. His scrotum was edematous and erythematous on right side with crepitus. Abdomen was warm on right side till umbilicus and had crepitus. He was in sepsis and had diabetic ketoacidosis, prerenal azotemia and mild impairment of liver function. A diagnosis of extensive Fournier gangrene with retroperitoneal involvement was made. Patient underwent scrotal exploration and aggressive debridement serially. Testis was spared. As patient improved with good wound care and glycemic control, wound was closed. Though our patient had retroperitoneal involvement without peritonitis, he was deferred laparotomy which significantly reduced the morbidity and mortality. It is one of the few reported case in the literature with retroperitoneal involvement.

Author Biography

M. Sabari Girieasen, Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu

Assistant professor, Institute of General Surgery

References

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Published

2020-04-23

Issue

Section

Case Reports