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Gastroenterologie 10. November 2015

Retroperitoneal necrotizing fasciitis secondary to Fournier’s gangrene

Background: The retroperitoneal necrotizing fasciitis is an extremely rare, usually lethal clinical entity and there are very few reported cases. If necrotizing fasciitis affects the retroperitoneum, a nonspecific signs and symptoms associate a higher mortality. For this reason, the diagnostic suspicion and the early surgical debridement are basic for a satisfactory result.

Methods: We present a case report of a 35-year-old black man admitted to the emergency room transferred from a county hospital. He developed an extensive retroperitoneal necrotizing fasciitis due to a Fournier’s gangrene.

Results: The patient was managed successfully by aggressive debridement and negative pressure therapy to control the extensive necrosis of the retroperitoneum, perineum, and scrotum.

Conclusions: In retroperitoneal necrotizing fasciitis and Fournier’s gangrene, an early diagnosis and treatment are the key factors for being successful. An extensive surgical debridement to healthy tissue associated with a broad-spectrum antibiotic is the mainstay of the treatment.

E. Sebastian-Valverde, C. Pañella-Vilamú, E. Membrilla-Fernández, J. J. Sancho-Insenser, L. Grande-Posa, European Surgery 5/2015

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