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ISSN 2305-7939 (Electronic)

2019, Number 1

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RCU 2019; 8 (1)

Scrotal Plasty in a Patient with Fournier gangrene

Luciano VAA, Valverde HP, Cervantes SJA, Varona VY

Language: Spanish
References: 19
Page: 54-60
PDF size: 760.01 Kb.


ABSTRACT

Clinical Case: Fournier gangrene is an urologic urgency with high mortality that is characterized by being a type of necrotizing fascitis mainly invading the subcutaneous fascia without muscular compromising. It is a rare condition. It affects the perineal and perianal area. The etiology is polymicrobial. Clinical Case: A 40 year-old, white male patient with a history of alcoholism arrives in an intoxicated state referring intense pain in the testicles that began 4 days ago. Both scrotums had volume increased. He also had nausea, vomiting, difficulty urinating, cloudy urine and headache. He refers any other symptomatology. Scrots change in coloration, increased volume, very painful on palpation. It is not possible to feel the testicles. Edematous penis. USG: both testicles of normal echogenicity, collection of large amount of ecomixta with internal echoes in possible relationship with abscesses. Surgery was performed in urgency, performing scrototomy and necrectomy, later in the definitive treatment he underwent plasty with a flap of the inner thigh. Conclusions: In patients with loss of the skin of the scrotum, the use of flaps from the inner side of the thigh is a useful alternative to achieve the approach to normal anatomy and allow normal functioning of the genital organs.


REFERENCES

  1. Yilmazlar T, Isik O, Ozturk E, Ozer A, Gulcu B, Ercan I. Fournier's Gangrene: Review of 120 Patients and Predictors of Mortality. Ulus Travma Acil Cerrahi Derg. 2014 [citado 14 Ene 2018];20(5):[aprox. 10 p.]. Disponible en: https://pdfs.semanticscholar.org/fcd6/9022f24 dbae66a65b35bf2c93522af9f4a31.pdf

  2. Sedano-Basilio JE, Cornejo-Dávila L, Trujillo- Ortiz M, Cantellano-Orozco G. Experiencia y revisión de la literatura en el manejo de gangrena de Fournier en una institución, 2008- 2015. Rev Mex Urol. 2016 [citado 14 Ene 2018];76(1):[aprox. 10 p.]. Disponible en: https://www.sciencedirect.com/science/article /pii/S2007408515001640

  3. McCormack M, Valiquette AS, Ismail S. Fournier's gangrene. A retrospective analysis of 26 cases in a Canadian hospital and literature review. Can UrolAssoc J. 2015 [citado 14 Ene 2018];9(5-6):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C4479662/

  4. Litchfield WR. The bittersweet demise of Herod the Great. J R Soc Med. 1998 [citado 14 Ene 2018];91(5):[aprox. 8 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C1296709/

  5. Nathan B. Fournier's gangrene: a historical vignette. J Can Surg. 1998 [citado 14 Ene 2018];41(1):[aprox. 10 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C3950066/

  6. Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier's gangrene. A clinical review. Arch Ital UrolAndrol. 2016 [citado 14 Ene 2018];88(3):[aprox. 13 p.]. Disponible en: http://www.pagepressjournals.org/index.php/a iua/article/download/aiua.2016.3.157/5956

  7. Ludolph I, Titel T, Beier JP, Schmitz M, Wullich B. Penile reconstruction with dermal template and vacuum therapy in severe skin and soft tissue defects caused by Fournier's gangrene and hidradenitis suppurativa. IntWound J. 2016 [citado 14 Ene 2018];13(1):[aprox. 9 p.]. Disponible http://onlinelibrary.wiley.com/doi/10.1111/iwj. 12235/full

  8. Fournier JA. Gangrene foudroyante de la verge. Medecin Pratique.1883;4:589-97.

  9. Shyam DC, Rapsang AG. Fournier's gangrene. Surgeon. 2013 [citado 14 Ene 2018];11(4):[aprox. 5 p.]. Disponible en: http://www.thesurgeon.net/article/S1479- 666X(13)00012-7/fulltext

  10. Sorensen MD, Krieger JN, Rivara FP, Broghammer JA, Klein MB, Mack CD, et al. Fournier's gangrene: population based epidemiology and outcomes. J Urol. 2009 [citado 14 Oct 2018];181(5):[aprox. 10 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C3042351/

  11. Benjelloun el B, Souiki T, Yakla N, Ousadden A, Mazaz K, Louchi A, et al. Fournier's gangrene: Our experience with 50 patients and analysis of factors affecting mortality. World J EmergSurg. 2013 [citado 14 Ene 2018];8(1):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C3616831/

  12. Eke N. Fournier's gangrene: a review of 1,726 cases. Br J Surg. 2000 [citado 14 Ene 2018];87(6):[aprox. 9 p.]. Disponible en: http://onlinelibrary.wiley.com/doi/10.1046/j.13 65-2168.2000.01679-9.x/epdf

  13. Katz N, Ramos J, Valtorta I, Neudeck V, Calot L, Trombini M, et al. Gangrena de Fournier 10 años de experiencia. RevChilUrol. 2009;74(4):349-54.

  14. Wróblewska M, Kuzaka B, Borkowski T, Kuzaka P, Kawecki D, Radziszewski P. Fournier's gangrene-Currentconcepts. Pol J Microbiol. 2014 [citado 14 Ene 2018];63(3):[aprox. 12 p.]. Disponible en: http://www.pjm.microbiology.pl/archive/vol63 32014267.pdf

  15. Agostini T, Mori F, Perello R, Dini M, Russo GL. Successful combined approach to a severe Fournier's gangrene. Indian J PlastSurg. 2014 [citado 14 Ene 2018];47(1):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C4075202/

  16. Sroczyński M, Sebastian M, Rudnicki J, Sebastian A, Agrawal AK. A complex approach to the treatment of Fournier's gangrene. AdvClinExp Med. 2013 [citado 14 Ene 2018];22(1):[aprox. 5 p.]. Disponible en: http://www.advances.umed.wroc.pl/pdf/2013/ 22/1/131.pdf

  17. Hakkarainen TW, Kopari NM, Pham TN, Evans HL. Necrotizing soft tissue infections: review and current concepts in treatment, systems of care, and outcomes. Curr Probl Surg. 2014 [citado 14 Ene 2018];51(8):[aprox. 8 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C4199388/

  18. Aridogan IA, Izol V, Abat D, Karsli O, Bayazit Y, Satar N. Epidemiological characteristics of Fournier's gangrene: a report of 71 patients. UrolInt. 2012 [citado 14 Ene 2018];89(4):[aprox. 6 p.]. Disponible en: https://www.karger.com/Article/Fulltext/34240 7

  19. García Marín A, Turegano Fuentes F, Cuadrado Ayuso M, Andueza Lillo JA, Cano Ballesteros JA, Pérez López M. Factores predictivos de mortalidad en la gangrena de Fournier: serie de 59 casos. CirEsp. 2015 [citado 14 Ene 2018];93(1):[aprox. 9 p.]. Disponible en: http://www.elsevier.es/es-revista-cirugiaespanola- 36-articulo-factores-predictivosmortalidad- gangrena-fournier- S0009739X14001560




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