2021 Volume 41 Issue 6 Pages 443-447
An 80-year-old man with a 2-day history of dyspnea and palpitation was transferred to our hospital with difficulty in moving. At the first examination performed by the emergency service staff, the patient’s consciousness level was I-3（JCS）, body temperature was 37.9℃, pulse was 117 bpm, and respiratory rate was 24/min. The blood pressure, which was initially 90/60 mm Hg, increased to 151/70 mm Hg after the start of fluid infusion. The scrotum was swollen and black in color, and emitted a bad odor. On digital examination of the rectum, a tumor was seen exposed from the anal canal, with bloody stool. Abdominal CT revealed subcutaneous emphysema from the scrotum to the pelvis. The patient was diagnosed as having Fournier’s Gangrene, and debridement and colostomy were carried out immediately. Infusion of the broad-spectrum antibiotics meropenem and clindamycin was started. The histopathological diagnosis was anal canal cancer. Fournier’s Gangrene is rarely caused by rectal or anal canal cancer. This disease is associated with a poor prognosis, with a mortality rate of 20％-50％; therefore, early diagnosis and surgery are indispensable.
