Presentation
Progressive scrotal and groin swelling and pain. Fournier gangrene?
Patient Data
Extremely advanced soft tissue gas collections and edema, invovling the scrotum, perineum, perianal regions. The gluteal regions and abdominal wall are also involved, more severe on the left. The retroperitenoum, perivesical, and perirectal spaces are also affected. Altogether findings are in line with advanced Fournier gangrene.
Abot 60 x 50 x 40 mm localized collection anterior to the rectum.
Other findings: small amount of gas in the bladder, reactive local lymph node enlargement, bilateral adrenal lesions, small hiatal hernia.
Case Discussion
Immediate surgical necrectomy and debridement, and left semicastration was performed. The rectal sphincter was found to be necrotic, and was resected, the operation being completed by transversostomy. The patient made a recovery.
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