摘要
<span style="font-family:Verdana;">Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. </span><b><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals.</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. <b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></span></b></span><b> </b><span style="font-family:Verdana;">During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. <i></i></span><i><i><span style="font-family:Verdana;">Echerichia coli</span></i><span style="font-family:Verdana;"></span></i> (<i><i><span style="font-family:Verdana;">E.</span></i><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:Verdana;"></span></i>)<span> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">was the frequently observed germ followed by <i></i></span><i><i><span style="font-family:Verdana;">Enterobacter fécalis</span></i><span style="font-family:Verdana;"></span></i> (<i></i></span><i><i><span style="font-family:Verdana;">E. fecalis</span></i><span style="font-family:Verdana;"></span></i>).<span style="font-family:;" "=""> </span><span style="font-family:Verdana;">They were resistant to the usual antibiotics. The germs were 100% sensitive to imipenem</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;"> and nitrofurantoin, 70% to gentamycin. The wide necrosectomy followed 3 weeks later by the inguinal flap pedicular plasty greatly improved the surgical procedures. Conclusion: Fournier’s syndrome is a medical surgical emergency whose prognosis is strongly related to early management.</span>
<span style="font-family:Verdana;">Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. </span><b><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals.</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. <b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></span></b></span><b> </b><span style="font-family:Verdana;">During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. <i></i></span><i><i><span style="font-family:Verdana;">Echerichia coli</span></i><span style="font-family:Verdana;"></span></i> (<i><i><span style="font-family:Verdana;">E.</span></i><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:Verdana;"></span></i>)<span> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">was the frequently observed germ followed by <i></i></span><i><i><span style="font-family:Verdana;">Enterobacter fécalis</span></i><span style="font-family:Verdana;"></span></i> (<i></i></span><i><i><span style="font-family:Verdana;">E. fecalis</span></i><span style="font-family:Verdana;"></span></i>).<span style="font-family:;" "=""> </span><span style="font-family:Verdana;">They were resistant to the usual antibiotics. The germs were 100% sensitive to imipenem</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;"> and nitrofurantoin, 70% to gentamycin. The wide necrosectomy followed 3 weeks later by the inguinal flap pedicular plasty greatly improved the surgical procedures. Conclusion: Fournier’s syndrome is a medical surgical emergency whose prognosis is strongly related to early management.</span>
作者
Koniba Keita
Sidiki Keita
Oulematou Coulibaly
Abdoulaye Diarra
Fodé Mory Keita
Boubacar Kone
Lassina Traoré
Salia Coulibaly
Amadou Traoré
Assitan Kone
Amadou Kassogué
Issa Traoré
Oumou Traoré
Ismael Konaré
Daouda Diallo
Drissa Traoré
Bacary T. Dembélé
Koniba Keita;Sidiki Keita;Oulematou Coulibaly;Abdoulaye Diarra;Fodé Mory Keita;Boubacar Kone;Lassina Traoré;Salia Coulibaly;Amadou Traoré;Assitan Kone;Amadou Kassogué;Issa Traoré;Oumou Traoré;Ismael Konaré;Daouda Diallo;Drissa Traoré;Bacary T. Dembélé(General Surgery Department, Hospital BSS, Kati, Mali;General Surgery “A” Department, Hospital Point-G, Bamako, Mali;Reference Health Centre of the Commune VI, Bamako, Mali;Medical Imaging Department, Hospital BSS, Kati, Mali;General Surgery Department, Hospital Gabriel Toure, Bamako, Mali;Urology Department, Hospital BSS, Kati, Mali;Anesthesia Resuscitation Department, Hospital BSS, Kati, Mali;General Surgery “B” Department, Hospital Point-G, Bamako, Mali)