Dragomir Liliana, Marina Virginia, Moscu Cosmina Alina, Anghele Mihaela
Clinical-Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University of Galati, 800201 Galati, Romania.
Medical Department of Occupational Health, Faculty of Medicine and Pharmacy, Dunărea de Jos University of Galati, 35 Str. Al. I. Cuza, 800201 Galati, Romania.
Diagnostics (Basel). 2022 Mar 31;12(4):876. doi: 10.3390/diagnostics12040876.
In this article, we present the case of a patient who hid the real reason for which he came to the emergency room. This patient in this case is a 61-year-old man, who presented to the emergency department for symptoms relevant to respiratory disease. However, the initial diagnosis turned out to be only the "tip of the iceberg" in the evolution and treatment of this patient. Fournier gangrene is a fulminant form of infectious necrotizing fasciitis of the perineal, genital, or perianal regions, which frequently affects men, but can also occur in women and children. It is a rare but life-threatening disease. Due to potential complications, it is important to diagnose Fournier gangrene as early as possible. Although antibiotics and aggressive debridement have been widely accepted as standard treatment, the mortality rate remains high. In many cases, the doctor's mission is much more difficult than it first seems. The challenges to which the doctor is subjected, especially in the emergency room, are immense. In establishing a diagnosis and emergency treatment, all parties involved-medical staff, on the one hand, and patients and relatives, on the other hand-must collaborate so that the outcome is a positive one. The overall conclusion of the medical team was that Fournier gangrene in the patient was the consequence of both the presence of an intrarectal foreign body, as well as excessive alcohol consumption. The case of our patient with Fournier gangrene and an intrarectal foreign body had a positive outcome due to quick, aggressive, and adequate medical and surgical management, as well as the fact that the patient had no other associated pathologies beyond alcohol "passion." Our patient's case is an example of the exceptional situations we sometimes encounter in medical practice.
在本文中，我们介绍了一位隐瞒前来急诊室真正原因的患者的病例。该病例中的患者是一名61岁男性，因与呼吸系统疾病相关的症状前往急诊科就诊。然而，最初的诊断结果在该患者的病情发展和治疗过程中仅仅是“冰山一角”。福尼尔坏疽是会阴部、生殖器或肛周区域感染性坏死性筋膜炎的一种暴发性形式，该病常影响男性，但也可发生于女性和儿童。它是一种罕见但危及生命的疾病。由于存在潜在并发症，尽早诊断福尼尔坏疽很重要。尽管抗生素和积极的清创术已被广泛接受为标准治疗方法，但死亡率仍然很高。在许多情况下，医生的任务比乍看起来要困难得多。医生面临的挑战，尤其是在急诊室，是巨大的。在进行诊断和急诊治疗时，所有相关方——一方面是医务人员，另一方面是患者及其亲属——必须合作，以便取得积极的结果。医疗团队得出的总体结论是，该患者的福尼尔坏疽是直肠内异物存在以及过量饮酒共同导致的结果。我们这位患有福尼尔坏疽和直肠内异物的患者，由于迅速、积极且充分的药物和手术治疗，以及该患者除了有饮酒“嗜好”外没有其他相关病症，最终获得了良好的治疗结果。我们患者的病例是我们在医疗实践中有时会遇到的特殊情况的一个例子。
