2016 Volume 36 Issue 4 Pages 797-802
The Fournier syndrome is a severe rapidly progressive necrotizing fasciitis of the perineum. We encountered a rectal cancer patient with Fournier gangrene. A 63-year-old man consulted our hospital for scrotal pain and swelling. Laboratory examination revealed that the WBC count (21900/mm3) and serum CRP level (45.6mg/dL) were elevated. Abdominal computed tomography showed wall thickening of the rectum and scrotum, and perirectal emphysema. We diagnosed the patient as having rectal cancer and Fournier gangrene. Emergency surgery was performed with debridement, lavage and drainage, and colostomy. From the 15th postoperative day, we attempted negative pressure wound therapy. Colonoscopic examination showed type 3 tumor in the lower rectum. On the 46th postoperative day, we performed laparoscopic Mile's operation (D2). Histopathology revealed a stage Ⅲ rectal cancer. The patient has discharged on the 122nd hospital day. It is considered very important to determine how a radical operation might be performed early in a rectal cancer patient with Fournier gangrene. The negative pressure closedown therapy was very effective for achieving an early operation in our case. Therefore, we report this case with a review of the literature.
