Medial thigh fasciocutaneous flaps for reconstruction of the scrotum following Fournier gangrene: A case report

Mwenibamba, Rodrigue Mupenda; Nteranya, Daniel Safari; Mukakala, Augustin Kibonge; Wabene, Christian Bisimwa; Rugendabanga, Angelique; Kibukila, Fabrice; Mitima, Nathan Bisimwa; Niyondiko, Jean Claude

doi:10.1002/ccr3.5747

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Therapeutic management is based on early surgical intervention consisting on excision of infected tissues and pus evacuation, appropriate antimicrobial treatment adapted after surgical bacteriological samples, and effective intensive care management managing sepsis signs or septic shock. 1 , 14 , 15 Colostomy stool diversion should be performed in cases of abscessed cancer to better control the infection. 13 , 16 …”

Section: Discussionmentioning

confidence: 99%

Spontaneous gas gangrene of the lower limb in a patient with rectal cancer: A fatal diagnostic pitfall

Mahjoubi

Rezgui

Mabrouk

et al. 2022

Clinical Case Reports

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Spontaneous or nontraumatic gas gangrene is a rare form of gangrenous disease. 1 It is a serious infection that usually occurs in immunocompromised patients. 2 Symptoms are common to several pathologies. The diagnosis may be delayed especially in the absence of a previous trauma. We report a case of spontaneous gas gangrene of the lower limb that was wrongly taken as thrombophlebitis. | CASE PRESENTATION | Case history and examinationA 43-year-old female patient, without comorbidities, was followed for locally advanced adenocarcinoma of the middle rectum, for 3 months. The carcinoma was classified T4N0M0, invaded the vagina, without any distant metastasis. Neoadjuvant radiochemotherapy was initiated, complicated by bone marrow aplasia, which required transfusions. She consulted for pain and functional impotence of the right lower limb, evolving for 3 days, without other associated signs.On examination, the patient was febrile at 38°C. Hemodynamic parameters were stable. Unlike the left lower limb, the right lower limb was swollen, warm, and painful at palpation with a positive Homan's sign. There were no skin necrosis, bullae, or cutaneous crepitus. The femoral pulse was present, whereas, the popliteal and pedal pulses were weak. The abdomen was soft, depressible, and painless. The rectal examination revealed a tumor of 5 cm from the anal margin, which was painful. | Differential diagnosis, investigations, and treatmentInitially, laboratory tests showed a white blood cell count of 7700 elements/mm 3 and a C-reactive protein (CRP) of 6 mg/L. Hemoglobin was of 8.2 g/dl. The chest X-ray was normal and the urinary cytobacteriological examination

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Section: Discussionmentioning

confidence: 99%

Spontaneous gas gangrene of the lower limb in a patient with rectal cancer: A fatal diagnostic pitfall

Mahjoubi

Rezgui

Mabrouk

et al. 2022

Clinical Case Reports

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Medial thigh fasciocutaneous flaps for reconstruction of the scrotum following Fournier gangrene: A case report

Mwenibamba

Nteranya

Mukakala

et al. 2022

Clinical Case Reports

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Fournier's gangrene, a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that leads to extensive soft tissue necrosis, remains a medical‐surgical emergency. The authors present a case of coverage of a scrotal loss of substance with testicular exposure by a medial fasciocutaneous flap of the unilateral thigh after debridement and initial medical treatment of Fournier's gangrene in a 50‐year‐old quadriplegic patient. The clinical examination at 8 months showed an aesthetic and functional result. The trophic‐cutaneous thigh flap that the authors propose for frail, elderly, and neurological subjects with low functional requirements allows coverage of the scrotal region with relatively thick skin, color, and texture close to those of the scrotum. It also offers technical simplicity, moderate scarring, and functional remnants at the price of less morbidity.

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Medial thigh fasciocutaneous flaps for reconstruction of the scrotum following Fournier gangrene: A case report

Cited by 2 publications

References 16 publications

Spontaneous gas gangrene of the lower limb in a patient with rectal cancer: A fatal diagnostic pitfall

Spontaneous gas gangrene of the lower limb in a patient with rectal cancer: A fatal diagnostic pitfall

Medial thigh fasciocutaneous flaps for reconstruction of the scrotum following Fournier gangrene: A case report

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