Early CT findings of fournier’s gangrene in a healthy male

Sherman, Joel; Solliday, Michael; Paraiso, E.; Becker, Joshua A.; Mydlo, Jack H.

doi:10.1016/s0899-7071(98)00073-4

Cited by 32 publications

(23 citation statements)

References 6 publications

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“…The imaging finding of soft-tissue air may be present before clinical crepitus is detected (19). However, the absence of subcutaneous air in the scrotum or perineum does not exclude the diagnosis of Fournier gangrene.…”

Section: Imaging Characteristicsmentioning

confidence: 99%

Fournier Gangrene: Role of Imaging

Levenson

Singh²,

Novelline³

2008

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Fournier gangrene is a rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with a potentially high mortality rate. Although the diagnosis of Fournier gangrene is often made clinically, emergency computed tomography (CT) can lead to early diagnosis with accurate assessment of disease extent. CT not only helps evaluate the perineal structures that can become involved by Fournier gangrene, but also helps assess the retroperitoneum, to which the disease can spread. Findings at CT include asymmetric fascial thickening, subcutaneous emphysema, fluid collections, and abscess formation. Subcutaneous emphysema is the hallmark of Fournier gangrene but is not seen in all cases. Compared with radiography and ultrasonography, CT provides a higher specificity for the diagnosis of Fournier gangrene and superior evaluation of disease extent; however, diagnosis and evaluation can also be performed with these other modalities. The administration of broad-spectrum antibiotics and aggressive surgical débridement of the nonviable tissue are both essential for successful treatment. An awareness of the CT features of Fournier gangrene is imperative for prompt diagnosis and effective treatment planning.

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Section: Imaging Characteristicsmentioning

confidence: 99%

Fournier Gangrene: Role of Imaging

Levenson

Singh²,

Novelline³

2008

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241

162

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“…Modern imaging techniques allow delineating the anatomy, to evaluate the extent of infection, and to detect eventual additional complications [21][22][23][24]. In most reports, US, CT and MRI were highly accurate for all these parameters.…”

Section: Epidemiological Clinical and Diagnostic Featuresmentioning

confidence: 99%

“…In comparison, MRI seems to have the widest field of view and reproducibility [22]. Since knowledge of outgrowth of the disease is necessary for planning exact surgical excision -in doubtful cases -any imaging technique should be applied preoperatively [21][22][23][24]. Identifying the source of the sepsis is the main challenge of the clinical diagnosis.…”

Section: Epidemiological Clinical and Diagnostic Featuresmentioning

confidence: 99%

Necrotizing Fasciitis of the Perineum and the Abdominal Wall-Surgical Approach

Ecker¹,

Baars²,

Töpfer³

et al. 2008

Eur J Trauma Emerg Surg

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Necrotizing fasciitis is a synergistic aerobical-anaerobical infection that rapidly spreads from its origin leading to foudroyant increasing soft tissue gangrene and systemic sepsis. In the perineal, perianal and genital regions it is referred to as Fournier's gangrene constituting a clinical entity with the gangrene of the abdominal wall. After a short presentation of the own experience with 17 patients the surgical approach to the life-threatening disease is presented reviewing the former and the recent literature. There is a worldwide consensus that immediate radical excision of the gangrene should be accompanied by intensive care measures. Functional and cosmetic defects are to be reconstructed in a second stage. However, morbidity and mortality remain high in spite of consequent treatment due to often associated significant co-morbidity of affected patients.

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“…(2,12) however, radiological evaluation, including CT and MRI, provides early detection in clinically indolent cases (14) . Various organism both aerobes and anaerobes have been identified as agents that acts synergistically in causing the disease.…”

Section: Discussionmentioning

confidence: 99%