Fournier’s gangrene by perianal abscess

Fournier’s gangrene by perianal abscess

To describe and analyze the cases of Fournier’s Gangrene caused by perianal abscess treated in a tertiary hospital in western Paraná, correlating possible factors that influence mortality, with emphasis on late diagnosis and therapy. A retrospective and descriptive case series was carried out based...

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Bibliographic Details
Published in:Journal of Coloproctology Vol. 40; no. 4; pp. 334 - 338
Main Authors: de Souza, Natiele Santos, Santos, Djoney Rafael dos, Westphalen, André Pereira, Netto, Fernando Antonio Campelo Spencer
Format: Journal Article
Language:English
Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Elsevier Editora Ltda 01-12-2020
Thieme Revinter Publicações Ltda
Subjects:
Abscess
Abscesso
Cirurgia colorretal
Colorectal surgery
Debridement
Desbridamento
Fasciite necrosante
Fournier’s gangrene
Gangrena de fournier
Necrotizing fasciitis
Original Article
Fasciite necrosante
Debridement
Abscesso
Fournier’s gangrene
Necrotizing fasciitis
Cirurgia colorretal
Abscess
Gangrena de fournier
Desbridamento
Colorectal surgery
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Summary:To describe and analyze the cases of Fournier’s Gangrene caused by perianal abscess treated in a tertiary hospital in western Paraná, correlating possible factors that influence mortality, with emphasis on late diagnosis and therapy. A retrospective and descriptive case series was carried out based on the analysis of medical records of patients with Fournier’s Gangrene due to perianal abscess from January 2012 to December 2017. Thirty-one patients with Fournier’s Gangrene due to perianal abscess were treated in the period: 26 men and 5 women. Mean age was 53.51 ± 14.5 years. The most prevalent comorbidity in this group was type 2 diabetes mellitus, showing a strong correlation with mortality. The mean time from disease progression, from the initial symptom to the admission at the service, was 9.6 ± 6.81 days. All patients were submitted to antibiotic therapy and surgical treatment, with a mean of 3.25 ± 2.89 procedures/patient. Seven (22.58%) patients died and all of them showed signs of sepsis on admission; only 2 patients with sepsis did not die. The presence of sepsis on admission and type 2 diabetes mellitus were strongly correlated with mortality. Descrever e analisar os casos de gangrena de Fournier por abscesso perianal atendidos em hospital terciário do oeste do Paraná, correlacionando possíveis fatores que influenciem a mortalidade, com ênfase ao diagnóstico e terapêuticas tardias. Realizou-se um estudo de série de casos, retrospectivo e descritivo baseado na análise de prontuários de pacientes portadores de gangrena de Fournier devido a abscesso perianal no período de Janeiro de 2012 à Dezembro de 2017. Foram tratados 31 pacientes com gangrena de Fournier por abscesso perianal no período, sendo 26 homens e 5 mulheres. A média de idade foi de 53,51 ± 14,5 anos. A comorbidade de maior prevalência neste grupo foi diabete melitus tipo 2, demonstrando forte correlação com mortalidade. A média do tempo de evolução da doença, do sintoma inicial até entrada no serviço, foi de 9,6 ± 6,81 dias. Todos os pacientes foram submetidos à antibioticoterapia e tratamento cirúrgico com média de 3,25 ± 2,89 procedimentos/paciente. Sete (22,58%) pacientes evoluíram para óbito e todos estes apresentavam sinais de sepse na admissão; apenas 2 pacientes com sepse não evoluíram a óbito. Presença de sepse a admissão e diabete melitus tipo 2 foram fortemente correlacionadas com mortalidade.
ISSN:2237-9363
2317-6423
DOI:10.1016/j.jcol.2020.07.004