Moslemi Mohammd Kazem, Sadighi Gilani Mohammad Ali, Moslemi Ali Akbar, Arabshahi Ali
Department of Urology, Kamkar Hospital, Qom Medical Sciences University, School of Medicine, Bajak Ave, Qom, Iran.
Cases J. 2009 Dec 3;2:9136. doi: 10.1186/1757-1626-2-9136.
Fournier gangrene is a rare necrotising fascitis of the perineum and genitals caused by a mixture of aerobic and anaerobic microorganisms. The first case was described by Baurienne in 1764 but the condition was named by Fournier in 1883 who reported the cases of five men with the condition with no apparent etiology. Infection most commonly arises from the skin, urethra, or rectal regions. Despite appropriate therapy, mortality in this disease is still high. We report a case of a low rectal malignancy presenting as Fournier gangrene. This case report serves to highlight an extremely unusual presentation of rectal cancer, a common surgical pathology.
The patient is a 48 years old Afghanian male that admitted with Fournier gangrene. In the course of medical and surgical treatment the presence of extensive rectal adenocarcinoma was discovered. After partial recovery, standard loop colostomy was inserted. Skin grafting of necrotic areas was performed and systemic rectal cancer chemotherapy initiated after full stabilization.
Fournier gangrene is an uncommon but life threatening condition with high associated mortality and morbidity. Usually there is an underlying cause for the development of Fournier gangrene, that if addressed correctly, can lead to a good outcome. Early diagnosis and treatment decrease the morbidity and mortality of this life threatening condition. Good management is based on aggressive debridement, broad spectrum antibiotics and intensive supportive care.
福尼尔坏疽是一种由需氧菌和厌氧菌混合感染引起的罕见的会阴部和生殖器坏死性筋膜炎。首例病例由鲍里安于1764年描述，但该病由福尼尔于1883年命名，他报告了5例病因不明的男性病例。感染最常起源于皮肤、尿道或直肠区域。尽管进行了适当治疗，该病的死亡率仍然很高。我们报告一例以福尼尔坏疽形式出现的低位直肠恶性肿瘤病例。本病例报告旨在突出直肠癌这一常见外科病理的一种极其不寻常的表现形式。
患者为一名48岁的阿富汗男性，因福尼尔坏疽入院。在医疗和手术治疗过程中，发现存在广泛的直肠腺癌。部分康复后，进行了标准的袢式结肠造口术。对坏死区域进行了植皮，并在完全稳定后开始进行全身性直肠癌化疗。
福尼尔坏疽是一种罕见但危及生命的疾病，具有较高的死亡率和发病率。通常福尼尔坏疽的发生有潜在原因，若正确处理，可带来良好预后。早期诊断和治疗可降低这种危及生命疾病的发病率和死亡率。良好的治疗基于积极的清创、广谱抗生素和强化支持治疗。
