虫垂炎穿孔に合併したFournier症候群の1例  [in Japanese] A CASE OF FOURNIER'S SYNDROME DUE TO PERFORATED APPENDICITIS  [in Japanese]

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Abstract

Fournier症候群は壊死性筋膜炎の特殊型で,下腹部から陰嚢にかけて皮下組織の急速な壊死が進行する重症感染症である.<br> 症例は11歳男児.来院時にすでに下腹部から陰嚢にかけて著明な発赤,腫脹,疼痛を認めた.腹部所見,超音波検査等より虫垂炎穿孔による汎発性腹膜炎と診断し,手術を施行した.術後,下腹部から陰嚢にかけて皮膚,皮下組織の溶解壊死が急速に進行し,患児はsepticな状態に陥った.壊死組織の徹底したデブリードメントおよびドレナージ手術により進行する感染が制御でき,救命することができた.<br> Fournier症候群は稀な疾患であるが,致死率も高く,虫垂炎の合併症としての認識が大切である.早期診断と早期治療(徹底したデブリードメント・ドレナージ)が救命する上で重要と思われた.

Fournier's syndrome is a specific type of necrotic fasciitis. It is a fulminating infection characterized by a rapid progress of necrosis of subcutaneous tissue covering from the lower abdomen to scrotum.<br> An 11-year-old boy was transferred to our clinic because of remarcable swelling and redness of the lower abdominal and scrotal skin with pair. Since physical findings and a ultrasonography were suggestive of panperitonitis due to perforation of acute appendicitis, an appendectomy and peritoneal drainage were carried out. After the surgery, necrosis of the skin and the fascia of the lower abdominal wall and scrotum developed rapidly and the patient became septic. Extensive debridement and drainage were needed to control the infection and to save the patient's life.<br> Fournier's syndrome is a rare entity but it has to be recognized as a life-threatening complication of acute appendicitis. Both early diagnosis and extensive surgical excision of the involved tissue with drainage are essential to save the patient.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 58(9), 2162-2166, 1997-09-25

    Japan Surgical Association

References:  16

Cited by:  5

Codes

  • NII Article ID (NAID)
    10008530604
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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