Outcomes in patients with Fournier’s gangrene originating from the anorectal region with a particular focus on those without perineal involvement
| Autor: | Hongcheng Lin, Hua-Xian Chen, Zhiyang Zhou, Rong Shi, Zhimin Liu, Qiu-Lan He, Zu-Qing Chen, Donglin Ren |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Anal fistula
perianal abscess medicine.medical_specialty medicine.medical_treatment Fournier’s gangrene 03 medical and health sciences 0302 clinical medicine medicine Abscess Gangrene business.industry Urinary diversion Gastroenterology Colostomy Fournier gangrene medicine.disease Surgery Perineum medicine.anatomical_structure anal fistula 030220 oncology & carcinogenesis Original Article 030211 gastroenterology & hepatology business protective colostomy Exploratory surgery |
| Zdroj: | Gastroenterology Report |
| ISSN: | 2052-0034 |
| Popis: | Background and aim Fournier’s gangrene (FG) is a fulminant infection in the external genital region and perineum. The present study explored the clinical features of FG originating from the anorectal region, from primary conditions such as anal fistulas and abscesses. Methods A retrospective analysis was performed in order to identify the factors associated with clinical outcomes in FG patients derived from two hospitals—the Sixth Affiliated Hospital of Sun Yat-sen University and People’s Hospital Affiliated to Fujian University of Traditional Chinese—over the period from May 2013 to April 2017. Results Sixty FG patients were included in this study. The common causative microorganisms cultured were Escherichia coli species. Genital and perirectal regional involvement was evident in 52 and 59 cases, respectively, although the perineum was unaffected in 7 cases (12%), as confirmed by imaging examination and surgical exploration. Management with early radical debridement and broad-spectrum antibiotic therapy is effective with an acceptably sepsis mortality (1.7%). Ten patients underwent protective colostomy. No patient underwent an orchidectomy and required urinary diversion. Conclusions FG originating from the anorectal region can be rapidly progressive and life-threatening. Infection can spread superiorly to the genital region without the involvement in perineal tissue. An aggressive surgical debridement of non-viable tissue is essential for satisfactory outcomes and a protective colostomy is not mandatory. |
| Databáze: | OpenAIRE |
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