A CASE OF FOURNIER'S GANGRENE DUE TO PERFORATED APPENDICITIS

Abstract

A 51-year-old man was diagnosed as having panperitonitis due to perforation of acute appendicitis, and an appendectomy and peritoneal drainage were carried out. Six days later, redness and swelling covering from the lower abdomen to scrotum appeared. Computed tomography of the abdomen revealed subcutaneous gas and abscess formation. Eight days after the operation, debridement of necrosed tissue was performed. Although the abscess extended forward along the necrosed fascia, subcutaneous fat tissue only had an edematous change. Bacteriologic cultures showed a mix of aerobic and anaerobic organisms, including Bacteroides and Streptococcus.
Fournier's gangrene 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. This is the 3^rd case report of Fournier's gangrene resulting from perforated appendicitis in Japan. We etiologically think that fournier's gangrene is associated with a drain through the abdominal wall and fascia in an appendectomy.