Fournier’s Gangrene Caused by Penetration of a Rectal Cancer with Uncontrolled Gastric Ulcer Bleeding

Abstract

Fournier’s gangrene is a rapidly progressing necrotizing fasciitis of the perineum and external genital organs. The disease is life-threatening and has a high mortality rate. Therefore, prompt diagnosis and treatment is needed. The present case was a 61-year-old man who complained of gluteal pain. The gluteal region and scrotum were swollen and partially necrotized, and a whole-circumference tumor was palpable on digital examination of the rectum. CT scans revealed rectal wall thickening, widespread gas filling the area from the gluteal region to the scrotum, and extravasation of contrast media from the stomach. We diagnosed Fournier’s gangrene caused by penetration of rectal cancer and upper gastrointestinal bleeding. For treatment, we first tried endoscopic hemostasis, but this proved troublesome because of the limited working area caused by a clot. We then used laparotomy to perform gastrectomy, transverse colostomy, and debridement of the perineal area. Here, we report this case, along with a review of the literature.