Slim K, Ben Slimene T, Largueche S, Bardi K, Guiga M, Mzabi R
Service de Chirurgie B, Hôpital Charles Nicolle, Tunis, Tunisie.
J Chir (Paris). 1988 Apr;125(4):270-5.
Of 9 patients with perineal gangrene secondary to abscess of anal margin, 7 presented deficiency states. Diagnosis was established after an average of 7.4 days following onset of signs, although the clinical picture was obvious and the lesions extended beyond the perineum towards the genital organs, buttocks or thigh. Essential therapy consisted of antibiotic cover, immediate and repeated surgical excision (average number of operations per patient = 6) and stools bypass by colostomy for severe perineal lesions. This resolutely aggressive treatment reduced mortality of this reputedly serious affection to 2 cases (22%), but morbidity was high and a perineoplasty was necessary in a third of the patients.
在9例因肛门边缘脓肿继发会阴坏疽的患者中，7例存在营养缺乏状态。尽管临床表现明显且病变超出会阴向生殖器官、臀部或大腿扩展，但平均在症状出现后7.4天确诊。基本治疗包括抗生素覆盖、立即且反复的手术切除（每位患者平均手术次数 = 6次）以及对严重会阴病变通过结肠造口术使粪便改道。这种坚决积极的治疗将这种公认的严重疾病的死亡率降至2例（22%），但发病率很高，三分之一的患者需要进行会阴成形术。
