Chhetri Suchit Thapa, Sah Sumit Kumar, Pathak Indra Dev, Pokhrel Niraaz, Thyayat Prem Khadka, Shah Nitesh Kumar
Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Int J Surg Case Rep. 2025 Jan;126:110734. doi: 10.1016/j.ijscr.2024.110734. Epub 2024 Dec 10.
Fournier's gangrene, a polymicrobial infection affecting the scrotum and perineal area, predominantly affects elderly males, presenting challenges in diagnosis and management. This report examines two cases, with a focus on the rare outcome of bilateral orchidectomy.
A 69-year-old diabetic male presented with severe penile and scrotal pain, leading to the diagnosis of Fournier's gangrene. In another case, a 91-year-old male with a history of Benign Enlargement of the Prostate experienced scrotal pain and ulcerative lesions, resulting in a rapid progression of gangrene. The surgical approaches encompassed multiple debridement and bilateral orchidectomy, underscoring the intricate nature of managing Fournier's gangrene.
Fournier's gangrene typically originates as a polymicrobial infection in the genitourinary or perianal regions, with common risk factors including diabetes, immunosuppression, and advanced age. Diagnosis often relies on clinical assessment, though imaging aids in complex cases. Early intervention with broad-spectrum antibiotics and repeated debridement remains the cornerstone of treatment.
Fournier's gangrene, a rare condition, poses diverse clinical presentations, management strategies, and outcomes. Early recognition, aggressive surgical debridement, and a multidisciplinary approach are essential in managing this condition.
福尼尔坏疽是一种影响阴囊和会阴区域的多微生物感染,主要影响老年男性,在诊断和治疗方面存在挑战。本报告检查了两例病例,重点关注双侧睾丸切除术这一罕见结果。
一名69岁的糖尿病男性出现严重的阴茎和阴囊疼痛,最终诊断为福尼尔坏疽。在另一例病例中,一名91岁有前列腺良性增生病史的男性出现阴囊疼痛和溃疡性病变,导致坏疽迅速发展。手术方法包括多次清创和双侧睾丸切除术,凸显了治疗福尼尔坏疽的复杂性。
福尼尔坏疽通常起源于泌尿生殖系统或肛周区域的多微生物感染,常见危险因素包括糖尿病、免疫抑制和高龄。诊断通常依赖临床评估,不过在复杂病例中影像学检查有辅助作用。早期使用广谱抗生素干预和反复清创仍然是治疗的基石。
福尼尔坏疽是一种罕见疾病,具有多样的临床表现、治疗策略和结果。早期识别、积极的手术清创以及多学科方法对于管理这种疾病至关重要。