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肛门周围脓肿和 Fournier 坏疽未引流的肛门周围败血病的诊断延误危险:病例系列。

Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier's gangrene: a case series.

机构信息

Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia

Western Sydney Local Health District, Westmead, New South Wales, Australia.

出版信息

BMJ Case Rep. 2020 Oct 4;13(10):e236503. doi: 10.1136/bcr-2020-236503.

Abstract

Fournier's gangrene (FG) is a rapidly progressing infective necrotising fasciitis of the perianal, perineal and genital region. It is characterised by its aggressive nature and high mortality rates of between 15% and 50%. While it has been commonly found to primarily develop from urological sources, there have been increasing reports of the role of colorectal sources as the underlying aetiology of FG. Presented is a case series of four FG presentations at a single institution during a 12-month period as a result of underlying untreated perianal disease highlighting its dangers in progressing to a deadly infection, advocating for early and aggressive surgical debridement, and the role of adjunct scoring systems, such as Laboratory Risk Indicator for Necrotising Fasciitis, in guiding clinical diagnosis.

摘要

Fournier 坏疽(FG)是一种迅速进展的感染性坏死性筋膜炎,发生于肛门周围、会阴和生殖器区域。其特征为侵袭性强,死亡率介于 15%至 50%之间。尽管它通常被认为主要源自泌尿道来源,但越来越多的报告指出结直肠来源是 FG 的潜在病因。本病例系列报告了在一家机构的 12 个月期间发生的 4 例 FG 病例,这些病例均源于未治疗的肛门周围疾病,强调了 FG 进展为致命感染的危险,提倡早期积极的手术清创,并强调了实验室危险指数坏死性筋膜炎等辅助评分系统在指导临床诊断中的作用。

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