A Case of Fournier's Gangrene after Transrectal Retroperitoneal Biopsy

Abstract

A 77-year-old woman was noted to have a tumor, gradually increasing in size on the dorsal side of her rectum on follow-up pelvic computed tomography (CT) after surgery for cervical cancer. Pelvic magnetic resonance imaging revealed a cystic mass with a nonuniform signal inside the tumor on T2-weighted images. She underwent transrectal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy and was discharged without any problems. However, 10 days later, she visited our hospital with the chief complaint of perianal pain. Pelvic CT showed gas retention in the perianal region. Therefore, the patient was diagnosed with Fournier's gangrene due to transrectal EUS-FNA. Urgent drainage was performed on the same day. She was discharged 10 days after this procedure but required repeat drainage because of abscess recurrence. EUS-FNA is a minimally invasive and safe procedure, but infection sometimes is a major complication. Especially with cystic masses, as in this case, it is necessary to consider the risk of infection when performing transrectal EUS-FNA.