A CASE OF FOURNIER'S GANGRENE DEVELOPED AFTER SURGERY FOR RECTAL PROLAPSE

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 67; no. 3; pp. 662 - 665
• Main Authors: KONUMA, Noriyoshi, OHARA, Moritaka, HAYASHI, Yuki, KIMIZUKA, Kei, MIYAKE, Hiroshi, ANDO, Kiyohiro
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2006
• Subjects: Fournier's gangrene
• ISSN: 1345-2843; 1882-5133; 1882-5133
• DOI: 10.3919/jjsa.67.662

This paper presents a case of Fournier's gangrene developed one year after surgery for rectal prolapse using procedure for prolapse and hemorrhoids (PPH). A 71-year-old woman was seen at the hospital because of anal pain. She had been administered adrenocortical steroid orally for rheumatoid arthritis for a long time, and had undergone an operation using PPH for rectal prolapse one year before entry. Local findings when she was seen included redness and swelling from the right gluteal region to right labia majora with tenderness. Pelvic CT scan revealed extensive subcutaneous emphysema at the same region. Fournier's gangrene was diagnosed and a colostomy and debridement were performed. Operative findings disclosed perforation at the rectal wall which was identical with the area where the mucosa was transected by stapling anastomosing device. To the best of our knowledge, this is the first case of Fournier's gangrene developed after surgery with PPH for rectal prolapse in Japan. It should be hept in mind that Fournier's gangrene may occur in such patients an their immune systems are suppressed or compromised.