Althunayyan Saqer, Karamitosos Evangelos
Department of Accident and Trauma, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2018 Apr;39(4):415-418. doi: 10.15537/smj.2018.4.21780.
Fournier gangrene is a rapidly progressive necrotizing fasciitis of the perianal and genitourinary area. Although typically affects men, we present here a rare disease founding in a pregnant woman. An obese 36-year-old female patient in her third trimester of pregnancy presented with a history of perianal pain and swelling. She was subsequently diagnosed with Fournier gangrene and underwent emergency cesarean section with a surgical debridement. The key to successful outcomes in such a complicated presentation of Fournier gangrene includes a high index of suspicion, fluid resuscitation, rapid administration of broad-spectrum antibiotics, and an early interdisciplinary approach by multiple teams. This helps share decisions and balance the risk-benefit of the emergency caesarian section without delaying the surgical debridement.
福尼尔坏疽是一种发生于肛周和泌尿生殖区域的快速进展性坏死性筋膜炎。虽然该病通常影响男性,但我们在此报告一例在孕妇中发现的罕见病例。一名36岁肥胖的孕晚期女性患者,有肛周疼痛和肿胀病史。她随后被诊断为福尼尔坏疽,并接受了急诊剖宫产及外科清创术。对于福尼尔坏疽这种复杂病情,成功治疗的关键包括高度的怀疑指数、液体复苏、迅速给予广谱抗生素,以及多个团队早期采取跨学科方法。这有助于共同做出决策,并在不延迟外科清创术的情况下平衡急诊剖宫产的风险和益处。