Lee Yung-Chin, Yang Wen-Horng, Wu Wen-Jeng, Chou Yii-Her, Huang Chun-Hsiung
Department of Urology, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2003 Dec;19(12):635-8. doi: 10.1016/S1607-551X(09)70518-2.
Fournier's disease, a form of necrotizing fasciitis, is a rapidly progressing subcutaneous infection of the male genitalia. We report a case of Fournier's disease with the unusual etiology of a perforated duodenum. This patient suffered from progressive right scrotal swelling after percutaneous transhepatic cholangeal drainage. Scrotal exploration revealed a large abscess with muscle necrosis that had spread up to the right retroperitoneal space. Radiologic studies and second abdominal exploration documented the origin as a perforated duodenum. The pus distribution in this case suggested that the infection process differed from that in previous reports. In future cases of Fournier's disease involving previous abdominal events, we recommend that abdominal origins be carefully surveyed before scrotal exploration.
福尼埃氏坏疽是坏死性筋膜炎的一种形式，是男性生殖器迅速进展的皮下感染。我们报告一例病因不寻常的福尼埃氏坏疽，病因是十二指肠穿孔。该患者在经皮经肝胆道引流术后出现进行性右侧阴囊肿胀。阴囊探查发现一个大脓肿伴肌肉坏死，脓肿已蔓延至右侧腹膜后间隙。影像学研究和再次腹部探查证实病源为十二指肠穿孔。该病例的脓液分布表明感染过程与既往报道不同。在未来涉及既往腹部疾病的福尼埃氏坏疽病例中，我们建议在阴囊探查前仔细检查腹部病源。
