A CASE OF FOURNIER'S GANGRENE WITH RECTAL CANCER

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  • 直腸癌にＦｏｕｒｎｉｅｒ’ｓ　ｇａｎｇｒｅｎｅを合併した１例

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Abstract

Fournier's gangrene is a specific type of fasciitis caused by an infection of the perianal tissue and progresses rapidly and widely. This disease is a poor risk factor for survival and its treatment is very difficult. We report a case of Fornier's gangrene wirh rectal cacner.<BR>A 60-year-old man was admitted to the hospital because of a high fever and perianal pain. His perineum was filled with black necrotic tissue. On the next day after admission, radical debridement, lavage and drainage were done, and sigmoid colostomy was established for fecal diversion. After that operation, the wound was washed by shower water every day to control local infection. A few days later, pelvic composed tomography revealed wall thickening of the rectum due to rectal cancer, and colonoscopy showed a rectal tumor which was diagnosed as well differentiated adenocarcinoma histologically. Unforturatly, he died of septic shock caused by MRSA before radical operation.<BR>In treating Fournier's gangrene with rectal cancer, therapeutic guidelines must be constituted from both angles of extermination of infection source and radical treatment for cancer. We experienced a case of advanced rectal cancer presented with a perianal abscess progressing to extended Fournier's gangrene. Our case is the sixth report in Japan. Further accumulation of reports and lively discussions of this disease are anticipated.

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