Presentation
Severe pain after surgery for peri-anal abscess 6 days back.
Patient Data
There is stranding with air locules in the right side of the perineum with extension into the ischio-anal and ischio-rectal spaces, pelvis (involving sub-cutaneous and muscular planes with involvement of Colle’s, Dartos, and deep perineal fascias) and left inguinal region along the spermatic cord up to the left hemi-scrotum around the testicle (with scrotal edema however, testicles appear within normal limits).
Air locules also extend in the anterior abdominal wall (up to opposite to the L2 level and involving Buck’s, Sarpa’s, and Camper’s fascias).
The liver is mildly enlarged in size with a normal position and has smooth borders. The liver is showing lower density on the venous phase than splenic parenchyma, most likely due to diffuse hepatic steatosis.
Case Discussion
Clinical presentation with post-operative status and current CT findings concern Fournier’s gangrene and diffuse hepatic steatosis with hepatomegaly, as described above.
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