Short communication, Note
Management of Fournier’s gangrene in a patient with diabetes and history of chronic alcohol abuse
Josip Španjol
; Klinika za urologiju, KBC Rijeka, Rijeka
Dražen Rahelić
; Klinika za urologiju, KBC Rijeka, Rijeka
Dean Markić
; Klinika za urologiju, KBC Rijeka, Rijeka
Alen Protić
; Klinika za anesteziologiju i intenzivno liječenje, KBC Rijeka, Rijeka
Goran Hauser
; Klinika za anesteziologiju i intenzivno liječenje, KBC Rijeka, Rijeka
Maksim Valenčić
; Klinika za urologiju, KBC Rijeka, Rijeka
Željko Fučkar
; Klinika za urologiju, KBC Rijeka, Rijeka
Abstract
Aim: In our case report we wanted to show a rare case of Fournier’s gangrene and
his surgical treatment with high educational value in clinical practice. Case report: A 53-
year old men presented with advanced gangrenous changes of the scrotum and penis as
well as the erythematous and swollen areas on the anterior abdominal wall, inguinal regions,
perineum and inner side of thighs. The patient was rapidly taken to the operating
room and underwent bilateral orchiectomy and radical excision of the necrotic masses until
the normal skin and fascia were found. Suprapubic urinary diversion was also performed
and the wound was left open. During his stay at our Department surgical toilette and banding
were performed daily. Along with the surgical treatment all the conservative measures
were taken, including proper intravenous hydration and antibiotic therapy. Once a wound
properly healed, plastic surgery and grafting was successfully performed giving satisfactory
cosmetic results. Discussion: Fournier’s gangrene is a life-threatening disorder in which infection
spreads along fascial planes, causing soft tissue necrosis. This disease affects mostly
patients with predisposing factors including diabetes, alcohol abuse, paraplegia and renal
insufficiency. Despite antibiotics and aggressive surgical debridement, Fournier’s gangrene
is associated with a high mortality rate and the interval from the onset of clinical symptoms
to the initial surgical intervention seems to be the most important prognostic factor. Conclusions:
Our case shows that Fournier’s gangrene remains a true urologic emergency, which
mandates aggressive initial surgical treatment.
Keywords
cystostomy; Fourniers gangrene; orchydectomy; surgical debridement
Hrčak ID:
112541
URI
Publication date:
2.12.2013.
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