W M Ghnnam1. 1. Department of General Surgery, Mansoura Faculty of Medicine, Egypt. wghnnam@gmail.com
Abstract
BACKGROUND: Fournier's gangrene (FG), caused by synergistic aerobic and anaerobic organisms, is a life-threatening disorder in which infection of the perineum and scrotum (can affect penis alone) spreads along fascial planes, leading to soft-tissue necrosis. Despite antibiotics and aggressive debridement, the mortality rate of FG remains high. MATERIALS AND METHODS: We analyzed 74 patients admitted to our institution's emergency surgical unit presenting with FG between January 2002 and January 2007, considering the anatomical site of infective gangrene, predisposing factors, etiological agents, and outcomes. RESULTS: All the 74 patients included in this study were males; their mean age was 51+/-10.8 years (21-72 years). The mean duration from the onset of symptoms to admission to the hospital was 3.74+/-2.09 days (1-8 days). The mean hospitalization time was 9.2+/- 6.6 days (1-31). Forty patients (54.05%) had FG secondary to anorectal conditions. No etiologic factors for FG were found in 27 patients (36.5%). Diabetes mellitus as a predisposing factor was found in 38 patients (51.35%). There was no definite predisposing factor in 24 patients (32.43%). The microbiological finding was polymicrobial in 48 patients (64.8%) and monomicrobial in 26 patients (35.1%). The most frequent bacterial organisms were Escherichia coli (75.6%). Simple sigmoid loop colostomy was done in one patient (1.4%). Unilateral orchidectomy was done in one case (1.4%). The overall mortality rate was 16 patients (21.6%). CONCLUSION: FG is a rapidly progressive, fulminant infection. Even with aggressive surgical and medical treatment, mortality of the disease is high. In the present cases, such a high ratio of 21.6% means that this disease is still serious and fatal in Egypt.
BACKGROUND: Fournier's gangrene (FG), caused by synergistic aerobic and anaerobic organisms, is a life-threatening disorder in which infection of the perineum and scrotum (can affect penis alone) spreads along fascial planes, leading to soft-tissue necrosis. Despite antibiotics and aggressive debridement, the mortality rate of FG remains high. MATERIALS AND METHODS: We analyzed 74 patients admitted to our institution's emergency surgical unit presenting with FG between January 2002 and January 2007, considering the anatomical site of infective gangrene, predisposing factors, etiological agents, and outcomes. RESULTS: All the 74 patients included in this study were males; their mean age was 51+/-10.8 years (21-72 years). The mean duration from the onset of symptoms to admission to the hospital was 3.74+/-2.09 days (1-8 days). The mean hospitalization time was 9.2+/- 6.6 days (1-31). Forty patients (54.05%) had FG secondary to anorectal conditions. No etiologic factors for FG were found in 27 patients (36.5%). Diabetes mellitus as a predisposing factor was found in 38 patients (51.35%). There was no definite predisposing factor in 24 patients (32.43%). The microbiological finding was polymicrobial in 48 patients (64.8%) and monomicrobial in 26 patients (35.1%). The most frequent bacterial organisms were Escherichia coli (75.6%). Simple sigmoid loop colostomy was done in one patient (1.4%). Unilateral orchidectomy was done in one case (1.4%). The overall mortality rate was 16 patients (21.6%). CONCLUSION: FG is a rapidly progressive, fulminant infection. Even with aggressive surgical and medical treatment, mortality of the disease is high. In the present cases, such a high ratio of 21.6% means that this disease is still serious and fatal in Egypt.
Authors: Dgj Avakoudjo; G Natchagandé; Pp Hounnasso; Ki Gandaho; F Hodonou; R Tore-Sanni; Mm Agounkpé; Ak Paré Journal: J West Afr Coll Surg Date: 2013 Jul-Sep
Authors: Antonio Tarasconi; Gennaro Perrone; Justin Davies; Raul Coimbra; Ernest Moore; Francesco Azzaroli; Hariscine Abongwa; Belinda De Simone; Gaetano Gallo; Giorgio Rossi; Fikri Abu-Zidan; Vanni Agnoletti; Gianluigi de'Angelis; Nicola de'Angelis; Luca Ansaloni; Gian Luca Baiocchi; Paolo Carcoforo; Marco Ceresoli; Alain Chichom-Mefire; Salomone Di Saverio; Federica Gaiani; Mario Giuffrida; Andreas Hecker; Kenji Inaba; Michael Kelly; Andrew Kirkpatrick; Yoram Kluger; Ari Leppäniemi; Andrey Litvin; Carlos Ordoñez; Vittoria Pattonieri; Andrew Peitzman; Manos Pikoulis; Boris Sakakushev; Massimo Sartelli; Vishal Shelat; Edward Tan; Mario Testini; George Velmahos; Imtiaz Wani; Dieter Weber; Walter Biffl; Federico Coccolini; Fausto Catena Journal: World J Emerg Surg Date: 2021-09-16 Impact factor: 5.469
Authors: Massimo Sartelli; Mark A Malangoni; Addison K May; Pierluigi Viale; Lillian S Kao; Fausto Catena; Luca Ansaloni; Ernest E Moore; Fred A Moore; Andrew B Peitzman; Raul Coimbra; Ari Leppaniemi; Yoram Kluger; Walter Biffl; Kaoru Koike; Massimo Girardis; Carlos A Ordonez; Mario Tavola; Miguel Cainzos; Salomone Di Saverio; Gustavo P Fraga; Igor Gerych; Michael D Kelly; Korhan Taviloglu; Imtiaz Wani; Sanjay Marwah; Miklosh Bala; Wagih Ghnnam; Nissar Shaikh; Osvaldo Chiara; Mario Paulo Faro; Gerson Alves Pereira; Carlos Augusto Gomes; Federico Coccolini; Cristian Tranà; Davide Corbella; Pietro Brambillasca; Yunfeng Cui; Helmut A Segovia Lohse; Vladimir Khokha; Kenneth Yy Kok; Suk-Kyung Hong; Kuo-Ching Yuan Journal: World J Emerg Surg Date: 2014-11-18 Impact factor: 5.469