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Fournier’s Gangrene: 13-Year Experience in a Tertiary Center, North Eastern Nigeria
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作者 Makama Baje Salihu Haruna Liman +4 位作者 Stephen Yusuf Aminu Umar Oladimeji Abraham Tunde Ayodele Olufikayo Oshagbemi Amur Ibrahim 《Open Journal of Urology》 2024年第7期407-414,共8页
Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving... Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving the scrotum of elderly men with different moods of occurrence each unpleasantly lethal. With varying types of presentation only one thing has remained constant;the poor prognosis of this condition. Purpose/Aim: Thus, it’s important to study the trends of the presentation of this condition laying emphasis on the challenges in the management of these patients;both the negative and positive prognostic factors. Materials and Methods: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Data was analyzed using SPSS version 29. Results: Data from 47 patients seen during the period of study were carefully collected and analyzed. The age range is 2 weeks to 97 years. There were two neonates, one at 2nd week of life and the other at 3rd week. Mortality rate is 36%. The average time duration before presentation for patients that died was two weeks, a minimum of 9 days prior to presentation and a maximum of 21 days, about 10 of which came in septic shock and the remaining presented with fever and very extensive necrotizing fasciitis of the perineum. All the patients that died had diabetes mellitus as a comorbidity except the neonate. All the patients that survived were much younger, all were below 60 years of age (2 weeks - 53 years). Conclusion: Here, we share our experience managing patients with Fournier’s gangrene in our facility in the past 13-year period from January 2011 to January 2024. . 展开更多
关键词 fournier’s gangrene Prognosis ELDERLY Presentation Treatment
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Fournier’s Gangrene: A Review of Fournier’s Gangrene Severity Index (FGSI) and Other Predictors of Mortality
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作者 Makama Baje Salihu Haruna Liman +3 位作者 Stephen Yusuf Aminu Umar Abraham Tunde Oladimeji Aremu Abdulrazak 《Open Journal of Urology》 2024年第7期391-399,共9页
Background: Fournier gangrene is an acute and rapidly progressive necrotizing fasciitis of the scrotum, perianal and perineal region of the body. It is a polymicrobial infection having an interplay of both anaerobic a... Background: Fournier gangrene is an acute and rapidly progressive necrotizing fasciitis of the scrotum, perianal and perineal region of the body. It is a polymicrobial infection having an interplay of both anaerobic and aerobic orgasms in a soup of microbial disaster. Fournier’s gangrene was also initially thought to be an idiopathic condition but a lot of risk factors have been associated now with this condition, both systemic risk factors and local. Systemic risk factors include diabetes mellitus, HIV/AIDS, cancers, chronic liver disease, chronic steroid use etc. The local risk factors include perineal injuries, watering can perineum, perianal abscess, chronic perineal itching etc. Purpose: The swiftly flourishing bacteria orgasms cause a similar disruptive event in the body of the patients both clinically and biochemically and these can be used to create a predictive score or index for patients in order to assess the disease severity and guide in the management and prognostication of this condition. Materials and Method: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Folders were retrieved and the medical records were reviewed. Results: Of the 50 patients reviewed, Male to female ratio is 24:1. The mean age is 56 years (2 weeks to 97 years). Mortality rate was 34%. There is a significant difference between delayed presentation/initial use of unorthodox treatment with mortality (p = 0.002). Of the 17 patients that died, 15 had FGSI > 9 and of the 33 patients that survived 29 had FGSI 9 is 88.2% while the mortality rate for those with FGSI Conclusion: knowledge of the predictors of its mortality is necessary in other to help stratify patients and ensure the best response by the caregivers. FGSI, delayed presentation/initial patronage of unorthodox care, and polymicrobial infection are important predictors of mortality in this condition. 展开更多
关键词 fournier’s gangrene FGsI Risk Factors MORTALITY
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Fournier’s gangrene after insertion of thermo-expandable prostatic stent for benign prostatic hyperplasia:A case report
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作者 Hee Chang Jung Yeong Uk Kim 《World Journal of Clinical Cases》 SCIE 2023年第27期6498-6504,共7页
BACKGROUND Thermo-expandable urethral stent(Memokath 028)implantation is an alternative treatment for older patients with lower urinary tract symptoms and benign prostatic obstruction.Following prostatic urethral sten... BACKGROUND Thermo-expandable urethral stent(Memokath 028)implantation is an alternative treatment for older patients with lower urinary tract symptoms and benign prostatic obstruction.Following prostatic urethral stent implantation,minor complications such as urinary tract infection,irritative symptoms,gross hematuria,and urethral pain have been observed;however,there are no reports of life-threatening events.Herein,we report a critical case of Fournier’s gangrene that occurred 7 years after prostatic stenting.CASE SUMMARY An 81-years-old man with benign prostatic hyperplasia(volume,126 ccs;as measured by transrectal ultrasound)had undergone insertion of a thermoexpandable urethral stent(Memokath 028)as he was unfit for surgery under general anesthesia.However,the patient had undergone a suprapubic cystostomy for recurrent acute urinary retention 4 years after the insertion of prostatic stent(Memokath 028).We had planned to remove the Memokath 028;however,the patient was lost to follow-up.The patient presented to the emergency department 3 years after the suprapubic cystostomy with necrotic changes from the right scrotum to the right inguinal area.In digital rectal examination,tenderness and heat of prostate was identified.Also,the black skin color change with foulsmelling from right scrotum to right inguinal area was identified.In computed tomography finding,subcutaneous emphysema was identified to same area.He was diagnosed with Fournier’s gangrene based on the physical examination and computed tomography findings.In emergency room,Fournier’s gangrene severity index value is seven points.Therefore,he underwent emergent extended surgical debridement and removal of the Memokath 028.Broad-spectrum intravenous antibiotics were administered and additional necrotic tissue debridement was performed.However,the patient died 14 days after surgery due to multiorgan failure.CONCLUSION If Memokath 028 for benign prostatic hyperplasia is not working in older patients,its rapid removal may help prevent severe complications. 展开更多
关键词 Urethral stents Minimally invasive surgery COMPLICATION fournier’s gangrene Benign prostatic hyperplasia Case report
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Fournier’s Gangrene in a Child Hospitalised in the Paediatric Emergency Department of the Gabriel Touré Teaching Hospital
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作者 Dembélé Adama Cissé Mohamed Elmouloud +10 位作者 Togo Pierre Tall Koureissi Maïga Belco Keïta Djeneba Doumbia Abdoul Karim Coulibaly Oumar Issa Amadou Ahamadou Ibrahim Coulibaly Bakary Traoré Kalirou Togo Boubacar 《Open Journal of Pediatrics》 CAS 2023年第2期214-219,共6页
Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following... Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following an insect bite. A rapid diagnosis and multidisciplinary care saved the patient. 展开更多
关键词 PEDIATRICs Infant fournier’s gangrene Insect Bite
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The role of quick Sepsis-related Organ Failure Assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier’s Gangrene Severity Index: Analysis of 69 patients
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作者 Bambang S.Noegroho Kuncoro Adi +3 位作者 Akhmad Mustafa Rais Syaeful Haq Zola Wijayanti Jason Liarto 《Asian Journal of Urology》 CSCD 2023年第2期201-207,共7页
Objective:Fournier’s gangrene is a rare but life-threatening infection disease with high mortality rate.The quick Sepsis-related Organ Failure Assessment(qSOFA)is a new and simpler scoring system that may identify pa... Objective:Fournier’s gangrene is a rare but life-threatening infection disease with high mortality rate.The quick Sepsis-related Organ Failure Assessment(qSOFA)is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome.The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier’s gangrene patients.Methods:This study is a case control with retrospective review of Fournier’s gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria.Participants were divided into two groups according to qSOFA score as high qSOFA(2-3)and low qSOFA(0-1).Results:From 69 patients,the mortality rate was 24.6%.The sensitivity of qSOFA score to predict mortality was 88.2%;the specificity was 94.2%;positive predictive value was 83.3%;negative predictive value was 96.1%;positive likelihood ratio was 15.2;negative likelihood ratio was 0.12;and the area under the receiver operating characteristic curve of qSOFA was 94.2%.There was significant association between qSOFA scale and mortality with p-value of 0.0001.The qSOFA score has strong positive correlation with Fournier’s Gangrene Severity Index(p<0.0001,r=0.704).Conclusion:qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier’s gangrene patients. 展开更多
关键词 fournier gangrene Quick sepsis-related Organ Failure Assessment Prognosis Organ failure severity index
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Experience in Management of Fournier’s Gangrene: A Report of 24 Cases 被引量:3
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作者 汪隆旺 韩晓敏 +8 位作者 刘梅 马彦 李兵 潘峰 李文成 汪良 杨雄 陈朝晖 曾甫清 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2012年第5期719-723,共5页
Fournier’s gangrene (FG) is an extremely aggressive and rapidly progressive polymicrobial soft tissue infection of the perineum,anal area or genitalial regions with a high mortality rate.The objectives of this study ... Fournier’s gangrene (FG) is an extremely aggressive and rapidly progressive polymicrobial soft tissue infection of the perineum,anal area or genitalial regions with a high mortality rate.The objectives of this study were to share our experience with the management of this serious infectious disease over the last 15 years.This retrospective study examined 24 patients diagnosed as having FG who were admitted to our hospital between March 1996 and December 2011.The gender,age,etiology,predisposing factors,laboratory findings,treatment modality,hospitalization time and spread of gangrene of the subjects were all recorded and analyzed.The results showed that the mean age of the patients was 48.33 years,the male-to-female ratio was 5:1 and the mortality rate was 20.8% (5/24).The most common predisposing factor was diabetes mellitus in 10 patients (41.6%),followed by alcohol abuse,obesity,neoplasms and immunosuppression.The most common etiology was peri-anal and peri-rectal abscesses (45.8%),followed by lesions of urogenital origin (33.3%) and cutaneous (8.3%) origin.No local pathologies could be identified in 3 (12.5%) patients.The most commonly isolated microorganisms were Escherichia coli (62.5%),followed by Enterococcus,Pseudomonas aeruginosa and Staphylococcus aureus.The median admission Fournier’s gangrene severity index (FGSI) score for survivors was 5.63±1.89 against 13.6±3.64 for non-survivors which was designed for predicting the disease severity in the series.Early diagnosis and immediate extensive surgical debridement were significant prognostic factors in the management of Fournier gangrene.Individualized reconstructive modalities for wound coverage were useful in that they repaired the tissue defect and improved the quality of life.We are led to conclude that Fournier’s gangrene is a severe condition with a high mortality.The Fournier’s gangrene severity index (FGSI) score at admission serves as a good predictor for the disease severity.Early diagnosis,surgical debridement and aggressive fluid therapy are significant prognostic factors in the management of Fournier gangrene.Individualized reconstructive surgery modalities for wound coverage are useful to correct the tissue defect and improve the quality of life. 展开更多
关键词 fournier’s gangrene surgical debridement fournier’s gangrene severity index
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Management protocol for Fournier’s gangrene in sanitary regime caused by SARS-CoV-2 pandemic:A case report 被引量:1
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作者 Agnieszka Grabińska Łukasz Michalczyk +2 位作者 Beata Banaczyk Tomasz Syryło Tomasz Ząbkowski 《World Journal of Clinical Cases》 SCIE 2021年第5期1215-1220,共6页
BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of ... BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of necrotizing fasciitis,which has a similar etiology and treatment strategy.CASE SUMMARY A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9°C,abdominal pain,and edema of the scrotum,the penis,the perineum,and the right gluteal region for 2 d.Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium,and the penis;along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum,the perineum,and the right gluteal region.The patient was diagnosed with FG,and was urgently qualified to undergo surgery in the Department of Urology.After performing the necessary examinations,a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed.After surgery,he was transferred to the intensive care unit for further management.CONCLUSION Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection. 展开更多
关键词 fournier’s gangrene Management Negative pressure wound therapy Treatment ORCHIECTOMY Case report Necrotic tissues sARs-CoV-2
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Fournier’s Gangrene: Experience with Two Severe Cases
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作者 Afoko Akisibadek Alekz Hoyte Williams +1 位作者 Afoko Vivian Yussif Adams 《Open Journal of Urology》 2021年第7期273-281,共9页
Fournier’s Gangrene is a formidable rare disease characterized by high mortality rates despite optimal medical and surgical management. It is an acute surgical emergency and requires a high degree of suspicion. The m... Fournier’s Gangrene is a formidable rare disease characterized by high mortality rates despite optimal medical and surgical management. It is an acute surgical emergency and requires a high degree of suspicion. The mainstay of treatment is swift open drainage and early aggressive surgical debridement of all necrotic tissue, followed by targeted antibiotic therapy. The authors report on two patients who were admitted to the surgical ward. Both presented with initial perianal sepsis complicated by painful swollen scrotum with rapid progression of gangrene of the scrotal skin and subcutaneous tissue, extensive cellulitis of the perineum, and in one patient crepitation of the anterior abdominal wall. A diagnosis of Fournier’s Gangrene was made and they were both managed by prompt resuscitation, broad-spectrum antibiotics, extensive debridement of all necrotic tissue in theatre, daily wound dressing, and repeated neurectomy on the ward. One of the patients had a colostomy done and the other a cystostomy to divert feces and relieve chronic urinary retention respectively. These patients were successfully treated despite the severity of their conditions which was complicated by severe sepsis in the face of limited diagnostic capabilities and resources, using a multidisciplinary approach and basic clinical monitoring as a guide. 展开更多
关键词 fournier’s gangrene surgical Debridement Necrotic Tissue sEPsIs Antibiotic Therapy
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Reconstruction of Scrotal and Perineal Defects in Fournier’s Gangrene
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作者 Hakim Chabak Amine Rafik +3 位作者 Mohammed Ezzoubi Mounia Diouri Naima Bahechar Abdessamad Chlihi 《Modern Plastic Surgery》 2015年第3期23-27,共5页
Fournier’s gangrene described in 1883 by Jean Alfred Fournier, still poses ethiopathogenic, evolutive and therapeutic problems. This is a therapeutic emergency;early diagnosis, medical and surgical treatments contrib... Fournier’s gangrene described in 1883 by Jean Alfred Fournier, still poses ethiopathogenic, evolutive and therapeutic problems. This is a therapeutic emergency;early diagnosis, medical and surgical treatments contribute to reducing mortality rate. Tissue defect engendered by infection and/or by its excision requires morphological and functional reconstruction. The choice of the reconstruction technique depends on several parameters: early or delayed coverage, the size of the defect, the local capital skin and the patient’s general condition. Through this study involving 95 cases of scrotal and perineal gangrene treated at the National Center of Burns and Plastic Surgery of Ibn Rochd University Hospital of Casablanca over a period of 10 years (2004-2014), we report our approach in the surgical management of defect secondary to Fournier’s gangrene. 展开更多
关键词 fournier’s gangrene scrotal and Perineal FLAP scrotal Advancement
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Fournier gangrene in an infant, complicated with severe sepsis and liver dysfunction: A case report
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作者 Ilirjana Bakalli Saimir Heta +1 位作者 Ermira Kola Ermela Celaj 《World Journal of Clinical Cases》 SCIE 2023年第30期7398-7402,共5页
BACKGROUND Fournier gangrene is a rare,life-threatening infection characterized by necrotizing fasciitis in the perineal,genital and/or lower abdominal regions.Despite its rarity,the unfavorable prognosis associated w... BACKGROUND Fournier gangrene is a rare,life-threatening infection characterized by necrotizing fasciitis in the perineal,genital and/or lower abdominal regions.Despite its rarity,the unfavorable prognosis associated with this disease is dependent on the timing of medical care.CASE SUMMARY A 3-month-old boy was admitted to our pediatric intensive care unit in critical condition after a 5-day history of fever and scrotal erythema with breaching skin lesions and swelling.Despite ambulatory antibiotic treatment,the child’s clinical condition deteriorated.At the time of admission,the child had necrotizing scrotal fasciitis that had spread to the abdomen.Following reanimation,the surgeon decided on an immediate intervention to rule out testicular torsion and to debride the affected area.Despite optimal antibiotic and supportive therapy,the patient developed severe sepsis with liver dysfunction,making treatment more challenging.CONCLUSION Recognizing Fournier gangrene,prompt referral to pediatric surgery,and appropriate antibiotic coverage are critical for avoiding sepsis and multiorgan dysfunction. 展开更多
关键词 fournier gangrene INFANT Early diagnosis sEPsIs Liver dysfunction Case report
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Outcomes in patients with Fournier’s gangrene originating from the anorectal region with a particular focus on those without perineal involvement 被引量:1
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作者 Hong-Cheng Lin Zu-Qing Chen +5 位作者 Hua-Xian Chen Qiu-Lan He Zhi-Min Liu Zhi-Yang Zhou Rong Shi Dong-Lin Ren 《Gastroenterology Report》 SCIE EI 2019年第3期212-217,I0003,共7页
Background and aim:Fournier’s gangrene(FG)is a fulminant infection in the external genital region and perineum.The present study explored the clinical features of FG originating from the anorectal region,from primary... Background and aim:Fournier’s gangrene(FG)is a fulminant infection in the external genital region and perineum.The present study explored the clinical features of FG originating from the anorectal region,from primary conditions such as anal fistulas and abscesses.Methods:A retrospective analysis was performed in order to identify the factors associated with clinical outcomes in FG patients derived from two hospitals—the Sixth Affiliated Hospital of Sun Yat-sen University and People’s Hospital Affiliated to Fujian University of Traditional Chinese—over the period from May 2013 to April 2017.Results:Sixty FG patients were included in this study.The common causative microorganisms cultured were Escherichia coli species.Genital and perirectal regional involvement was evident in 52 and 59 cases,respectively,although the perineum was unaffected in 7 cases(12%),as confirmed by imaging examination and surgical exploration.Management with early radical debridement and broad-spectrum antibiotic therapy is effective with an acceptably sepsis mortality(1.7%).Ten patients underwent protective colostomy.No patient underwent an orchidectomy and required urinary diversion.Conclusions:FG originating from the anorectal region can be rapidly progressive and life-threatening.Infection can spread superiorly to the genital region without the involvement in perineal tissue.An aggressive surgical debridement of nonviable tissue is essential for satisfactory outcomes and a protective colostomy is not mandatory. 展开更多
关键词 fournier’s gangrene perianal abscess anal fistula protective colostomy
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How likely is septic shock to develop in a patient with Fournier’s gangrene?A risk prediction model based on a 7-year retrospective study
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作者 Yang Yang Li-Chun Wang +5 位作者 Xin-Yang Yu Xiao-Fei Zhang Zhong-Qing Yang Yang-Zi Zheng Bin-Yan Jiang Lei Chen 《Gastroenterology Report》 SCIE EI 2022年第1期430-439,共10页
Background Fournier’s gangrene(FG)is a rare life-threatening form of necrotizing fasciitis.The risk factors for septic shock in patients with FG are unclear.This study aimed to identify potential risk factors and dev... Background Fournier’s gangrene(FG)is a rare life-threatening form of necrotizing fasciitis.The risk factors for septic shock in patients with FG are unclear.This study aimed to identify potential risk factors and develop a prediction model for septic shock in patients with FG.Methods This retrospective cohort study included patients who were treated for FG between May 2013 and May 2020 at the Sixth Affiliated Hospital,Sun Yat-sen University(Guangzhou,China).The patients were divided into a septic shock group and a non-septic shock group.An L1-penalized logistic regression model was used to detect the main effect of important factors and a penalized Quadratic Discriminant Analysis method was used to identify possible interaction effects between different factors.The selected main factors and interactions were used to obtain a logistic regression model based on the Bayesian information criterion.Results A total of 113 patients with FG were enrolled and allocated to the septic shock group(n=24)or non-septic shock group(n=89).The best model selected identified by backward logistic regression based on Bayesian information criterion selected temperature,platelets,total bilirubin(TBIL)level,and pneumatosis on pelvic computed tomography/magnetic resonance images as the main linear effect and Na^(+)×TBIL as the interaction effect.The area under the ROC curve of the probability of FG with septic shock by our model was 0.84(95%confidence interval,0.78–0.95).The Harrell’s concordance index for the nomogramwas 0.864(95%confidence interval,0.78–0.95).Conclusion We have developed a prediction model for evaluation of the risk of septic shock in patients with FG that could assist clinicians in identifying critically ill patients with FG and prevent them from reaching a crisis state. 展开更多
关键词 fournier’s gangrene sEPsIs septic shock NOMOGRAM risk prediction
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Fournier’s gangrene complicating severe acute pancreatitis: a case report and literature review
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作者 Gautham Krishnamurthy Patta Radhakrishna +1 位作者 Aswin Khanna Karthikeyan Damodaran 《Journal of Pancreatology》 2021年第3期130-133,共4页
Severe acute pancreatitis is commonly associated with pancreatic and extrapancreatic necrosis(EPN).Progressive EPN leading to necrotizing fasciitis of the retroperitoneum and abdominal wall has been reported.However,e... Severe acute pancreatitis is commonly associated with pancreatic and extrapancreatic necrosis(EPN).Progressive EPN leading to necrotizing fasciitis of the retroperitoneum and abdominal wall has been reported.However,extension of retroperitoneal necrosis to the scrotum causing Fournier’s gangrene is uncommon.We present a case of 39-year-old male admitted with severe acute pancreatitis requiring prolonged mechanical ventilation.He was managed with percutaneous drainage and culture specific antibiotics during the 1st month of hospital stay.During the 3rd month of hospital stay,the patient started developing pain and ulceration over the scrotum.He was diagnosed with Fournier’s gangrene based on clinical examination and was planned for debridement.During surgery,the track extending up to the deep inguinal ring was widened and drain was placed into the right lateral pelvic wall through the deep ring via a separate stab incision to reduce further scrotal wound contamination.The case highlights a rare but potentially fatal complication of Fournier’s gangrene following severe acute necrotizing pancreatitis and the importance of measures to prevent further contamination of scrotum after surgical debridement.Concomitant management of two potentially fatal conditions poses numerous challenges. 展开更多
关键词 Case report DEBRIDEMENT Extrapancreatic necrosis fournier’s gangrene Necrotizing fasciitis severe acute pancreatitis
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Enterostomy can decrease the mortality of patients with Fournier gangrene 被引量:3
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作者 Yan-Dong Li Wei-Fang Zhu +1 位作者 Jian-Jun Qiao Jian-Jiang Lin 《World Journal of Gastroenterology》 SCIE CAS 2014年第24期7950-7954,共5页
AIM: To determine the significance of enterostomy in the emergency management of Fournier gangrene.
关键词 fournier gangrene Necrotizing fasciitis ENTEROsTOMY sURGERY INFECTION
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Rectal cancer and Fournier's gangrene- current knowledge and therapeutic options 被引量:6
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作者 Tomislav Bruketa Matea Majerovic Goran Augustin 《World Journal of Gastroenterology》 SCIE CAS 2015年第30期9002-9020,共19页
Fournier's gangrene(FG) is a rapid progressive bacterial infection that involves the subcutaneous fascia and part of the deep fascia but spares the muscle in the scrotal,perianal and perineal region. The incidence... Fournier's gangrene(FG) is a rapid progressive bacterial infection that involves the subcutaneous fascia and part of the deep fascia but spares the muscle in the scrotal,perianal and perineal region. The incidence has increased dramatically,while the reported incidence of rectal cancer-induced FG is unknown but is extremely low. Pathophysiology and clinical presentation of rectal cancer-induced FG per se does not differ from the other causes. Only rectal cancer-specific symptoms before presentation can lead to the diagnosis. The diagnosis of rectal cancer-induced FG should be excluded in every patient with blood on digital rectal examination,when urogenital and dermatological causes are excluded and when fever or sepsis of unknown origin is present with perianal symptomatology. Therapeutic options are more complex than for other forms of FG. First,the causative rectal tumor should be removed. The survival of patients with rectal cancer resection is reported as 100%,while with colostomy it is 80%. The preferred method of rectal resection has not been defined. Second,oncological treatment should be administered but the timing should be adjusted to the resolution of the FG and sometimes for the healing of plastic reconstructive procedures that are commonly needed for the reconstruction of large perineal,scrotal and lower abdominal wall defects. 展开更多
关键词 fournier's gangrene NECROTIZING FAsCIITIs Proctological examination NECROTIZING soft tissueinfections Oncological TREATMENT RECTAL cancer surgical TREATMENT RECONsTRUCTIVE surgery
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Fournier's Gangrene: Experience with Management of 46 Cases in a Tertiary Institution
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作者 Sani Ali Aji Sani Usman Alhassan Musa Muhammad Ujudud 《Open Journal of Urology》 2012年第3期109-112,共4页
Background: Fournier's gangrene is a rapidly spreading necrotizing gangrene affecting the perineum, Perianal and genital regions but remarkably sparing the testicles, bladder and rectum due to their separate blood... Background: Fournier's gangrene is a rapidly spreading necrotizing gangrene affecting the perineum, Perianal and genital regions but remarkably sparing the testicles, bladder and rectum due to their separate blood supply which is directly from the aorta. The aim of this study is to share our experience with the management of 46 cases. Patients and method: We retrospectively analysed the medical records of 46 patients admitted with Fournier's gangrene between April 2005 and December 2011 in the urology unit of Aminu Kano Teaching Hospital. Data extracted from these include age, sex, hospital stay, premorbid diseases, mobility, mortality, laboratory investigations and treatments carried out. Results: Fourty six patients were admitted and managed for Fournier's gangrene during the study period. All the patients were male and mean age was 50 years (range 20 - 80 years). Five patients died (10.90%) mortality, 41 (89.10%) patients survived. The shortest hospital stay was 13 days and longest was 120 days. 45.7% of the patients had urethral stricture with watering can perineum as predisposing factor, 16 (34.80%) had diabetes mellitus, 7 (15.2%) had perineal injuries as the predisposing factors while 5 (10.90%) patients had uraemia and one patient (2.20%) each had bladder tumour and scrotal abscess as their predisposing factors, in 3 patients (6.50%) it was idiopathic. Only 34 (73.90%) patients had wound swab microscopy culture and sensitivity on admission. The culture grew Klebsiella spp. in 9 (26.50%), Staph aureus and E. coli in 5 (10.90%) of cases each, while Gram positive rod and Gram negative Cocci with 4 (11.80%) and 6 (17.60%) respectively. Conclusion: Fournier's gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals, is now changing pattern. Extensive surgical debridement and broad spectrum intravenous antibiotics remain the mainstay of treatment. 展开更多
关键词 fournier's gangrene MANAGEMENT CHANGING Pattern
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Gangrene of the External Genitalia at the Regional University Hospital Center of Ouahigouya: Epidemiological Profile and Therapeutic Aspects
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作者 Tiéoulé Mamadou Traore Clô +2 位作者 taire Alexis Marie Kiemdiba Donega Yameogo Moussa Kabore Souleymane Ouedraogo 《Open Journal of Urology》 2020年第6期184-191,共8页
<strong>Introduction:</strong> Gangrene of extern genitary organs is a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that results from a polymicrobial infection. Mortalit... <strong>Introduction:</strong> Gangrene of extern genitary organs is a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that results from a polymicrobial infection. Mortality remains high despite advances in resuscitation. We report the experience of the surgery department of the Regional University Hospital Center (CHUR) of Ouahigouya in order to describe the epidemiological profile and the therapeutic aspects of GOGE. <strong>Patients and</strong> <strong>methods:</strong> We carried out a descriptive and analytical retrospective study collecting 41 cases of Fournier’s gangrene treated over 63 months (from March 2013 to July 2018) in the surgical department of the Ouahigouya regional university hospital center. Ethical clearance was taken from the institutional ethics committee. <strong>Results:</strong> The mean age of the patients was 65.02 ± 17.92 years with extremes of 23 years and 95 years. All patients were male. Urologic causes were the most common with 36.58% of cases. The average consultation time was 15.44 ± 16.04 days with extremes of 1 day and 60 days. All patients received resuscitation, bi or triantibiotherapy and surgical debridement. The mortality rate was 24.39%. The mean duration of hospitalization was 10.83 ± 6.257 days with extremes of 1 day and 60 days. <strong>Conclusion:</strong> The Fournier’s gangrene always has a very high lethality. Improving the prognosis requires fast and effective management. 展开更多
关键词 fournier’s gangrene EPIDEMIOLOGY Emergency MORTALITY
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Fournier坏疽临床诊断和综合治疗1例报告及文献复习
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作者 孔祥力 石凯 +3 位作者 张喜 薛岩 洪雷 张修航 《吉林大学学报(医学版)》 CAS CSCD 北大核心 2024年第4期1144-1149,共6页
目的:探讨Fournier坏疽患者临床表现、诊断和治疗方法,以提高临床医生对该病的认识。方法:收集1例Fournier坏疽患者的临床症状、体征、影像学表现和手术结果等临床资料,并复习相关文献,总结Fournier坏疽患者的临床特点、诊断和治疗方法... 目的:探讨Fournier坏疽患者临床表现、诊断和治疗方法,以提高临床医生对该病的认识。方法:收集1例Fournier坏疽患者的临床症状、体征、影像学表现和手术结果等临床资料,并复习相关文献,总结Fournier坏疽患者的临床特点、诊断和治疗方法。结果:患者,男,42岁,因会阴、阴囊和肛周感染13 d入院。既往史,急性髓系白血病10个月,于当地医院行化疗8个疗程。腹部CT提示,左侧腹股沟区软组织增厚,密度增高浑浊。血常规,白细胞23.99×10^(9)L^(-1)。创面分泌物培养为大肠埃希菌和阴沟肠杆菌。专科检查,患者阴囊和左臀部近肛门处皮肤坏死,色黑,质硬,坏死皮肤周围溶解,与基底及周围正常皮肤分离,可见少量脓性渗出,无明显异味,创面周围皮肤红肿明显;肛门指诊无出血,未探及窦道。患者入院后当天行急诊清创手术,术后予以换药和多次留置简易负压后行会阴部皮瓣修复及皮肤移植手术,术后患者恢复良好,功能正常,无并发症。结论:Fournier坏疽起病急且进展快,患者临床表现无特异性,感染范围与疾病进展不一致。确诊主要依靠术中探查。反复多次的根治性手术是其主要治疗手段。该病预后较好,复发率低,术后仍需长期随访。 展开更多
关键词 fournier坏疽 坏死性筋膜炎 负压治疗 会阴部 皮肤移植 皮瓣修复
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Fournier坏疽2例
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作者 马有才 张秀梅 +1 位作者 景钦香 杜丽霞 《临床皮肤科杂志》 CAS CSCD 北大核心 2024年第2期104-107,共4页
报告2例Fournier坏疽。例1.男,30岁。阴囊、阴茎肿大伴破溃、发热8 d。皮肤科检查:阴茎及阴囊皮肤多处大面积破溃、坏死,最大4 cm×10 cm、表面有黑痂,周围弥漫性肿胀伴渗液,其上可触及捻发音,流出大量尸臭味脓性分泌物。例2.男,40... 报告2例Fournier坏疽。例1.男,30岁。阴囊、阴茎肿大伴破溃、发热8 d。皮肤科检查:阴茎及阴囊皮肤多处大面积破溃、坏死,最大4 cm×10 cm、表面有黑痂,周围弥漫性肿胀伴渗液,其上可触及捻发音,流出大量尸臭味脓性分泌物。例2.男,40岁。下腹部疼痛伴阴囊肿胀7 d。皮肤科检查:阴囊、阴茎皮肤大片坏死、破溃,最大为6 cm×12 cm,挤压双侧腹股沟区有恶臭味淡黄色脓液流出。2例患者经及时应用广谱抗生素和急诊手术彻底清创引流及理疗等对症治疗。例1患者因脓毒血症死亡,例2患者术中清创面积扩大,择期行皮瓣移植。 展开更多
关键词 fournier坏疽
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手术清创联合负压引流灌洗治疗Fournier坏疽患者40例临床分析
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作者 周鑫 孔祥力 +7 位作者 张喜 赵景春 洪雷 张修航 薛岩 张楠 于家傲 石凯 《吉林大学学报(医学版)》 CAS CSCD 北大核心 2023年第5期1337-1343,共7页
目的:观察40例Fournier坏疽(FG)患者临床表现和治疗效果,探讨改良后负压引流灌洗技术在FG治疗中的应用前景。方法:采用病历回顾性分析法分析本科室收集的40例FG患者的临床资料,并进行手术清创联合负压灌洗技术治疗。记录术前患者病因、... 目的:观察40例Fournier坏疽(FG)患者临床表现和治疗效果,探讨改良后负压引流灌洗技术在FG治疗中的应用前景。方法:采用病历回顾性分析法分析本科室收集的40例FG患者的临床资料,并进行手术清创联合负压灌洗技术治疗。记录术前患者病因、并发症、临床表现、病理检查结果、实验室检查结果、创面细菌培养和术后住院时长,观察患者创面愈合情况和预后远期随访情况。结果:40例患者中,男性35例,女性5例,年龄22~81岁,伴有肛周感染28例,糖尿病11例,外伤5例,截瘫致压疮1例,无明显诱因6例。病理检查,慢性化脓性炎症伴脓肿形成;采用手术清创,根据创面结果,覆盖负压同时改良引流灌洗方式进行创面治疗。患者全部治愈出院,无复发,平均住院时间24.65 d,25例肛周脓肿患者术后未出现明显狭窄;8例累及阴囊患者恢复良好,外形及功能正常;7例植皮患者皮片生长良好;2例皮瓣修复患者皮瓣血供良好,未出现红肿破溃;8例累及下肢患者患部运动及感觉功能恢复良好,未出现明显残疾及瘢痕增生。结论:采用手术清创联合负压引流灌洗技术治疗FG有利于观察创面的变化,减少换药次数,缩短住院时间,提高治愈率,值得临床推广使用。 展开更多
关键词 fournier坏疽 坏死性筋膜炎 负压引流 皮肤移植 皮瓣修复
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