Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report

Mustafa Abdullah Abbas; Maryam Tawfiq Aburezq; Amal Hassan Elsabbagh

doi:doi:10.11648/j.js.20221001.13

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Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report

Mustafa Abdullah Abbas, Maryam Tawfiq Aburezq, Amal Hassan Elsabbagh

Published in Journal of Surgery (Volume 10, Issue 1)

Received: 24 December 2021 Accepted: 13 January 2022 Published: 20 January 2022

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Abstract

Fournier’s gangrene and retroperitoneal abscess are rare complications of late presentation of perforated acute appendicitis. This case report discusses the case of a 46-year-old male patient who presented with 5 days history of progressive abdominal pain and was admitted to our department as a case of complicated perforated acute appendicitis followed by retroperitoneal abscess formation and Fournier’s Gangrene few days later. The patient had a hospital stay of 53 days, during which he underwent diagnostic laparoscopy and appendectomy, computerized tomography guided percutaneous abscess incision and drainage for the retroperitoneal abscess and multiple scrotal debridement surgeries for the Fournier’s gangrene, in addition to the drain care and intravenous antibiotic course he received. Diabetes mellitus is one of the most common risk factors of Fournier’s gangrene, which was newly detected in our patient six months earlier. Fournier’s gangrene is ten times more common in males than in females, especially in their third and sixth decade of life. It is life-threatening and has unfavorable prognosis that indicates early detection and aggressive surgical and medical intervention with a multidisciplinary approach, including fluid resuscitation, immediate initiation of broad-spectrum antibiotics and aggressive debridement of the necrotic tissue; in addition to the respiratory and hemodynamic support to improve the prognosis and overall outcome and to maximize the chances of survival.

Published in	Journal of Surgery (Volume 10, Issue 1)
DOI	10.11648/j.js.20221001.13
Page(s)	8-14
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Fournier’s Gangrene, Retroperitoneal Abscess, Acute Appendicitis

References

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[2]	J. D. Kauffman, M. O’Brien, C. W. Snyder, S. A. Rottgers, D. A. Rideout, and N. M. Chandler, “Acute appendicitis complicated by necrotizing fasciitis in a teenager,” J. Pediatr. Surg. Case Rep., vol. 37, pp. 77–82, 2018.
[3]	M. Hejase, J. Simonin, R. Bihrle and C. Coogan, "Genital fournier's gangrene: experience with 38 patients", Urology, vol. 47, no. 5, pp. 734-739, 1996. Available: 10.1016/s0090-4295(96)80017-3.
[4]	S. Chernyadyev et al., "Fournier’s Gangrene: Literature Review and Clinical Cases", Urologia Internationalis, vol. 101, no. 1, pp. 91-97, 2018. Available: 10.1159/000490108.
[5]	J. George, A. Raja, D. Chun Hei Li and H. Joshi, "Fournier's gangrene: diagnosis and management aided by repeated clinical examination and ultrasound", BMJ Case Reports, p. bcr2016217409, 2017. Available: 10.1136/bcr-2016-217409.
[6]	K. J, S. G, B. G, G. I, S. S and D. J, "Management of fournier's gangrene: case report and literature review", PubMed, 2022. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/21830457/.
[7]	P. B. Sarmah, M. Khan, and M. Zilvetti, “Fournier’s gangrene secondary to an acutely inflamed appendix herniating into the deep inguinal ring,” J. Surg. Case Rep., vol. 2015, no. 3, pp. rjv027–rjv027, 2015.
[8]	R. Brown-Forestiere, A. Furiato, N. P. Foresteire, J. S. Kashani, and A. Waheed, “Acute appendicitis: Clinical clues and conundrums related to the greatest misses,” Cureus, vol. 12, no. 5, p. e8051, 2020.
[9]	J. Rad and J. Foreman, "Fournier Gangrene", Ncbi.nlm.nih.gov, 2022. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK549821/.
[10]	N. A. Alzerwi, M. Alshanwani, A. S. Alsultan, S. Almutairi, Y. I. Aldebasi, and B. I. Ali, “Perforated appendicitis as a source of Fournier’s gangrene in an immunocompetent male,” Int. Surg. J., vol. 6, no. 10, p. 3813, 2019.
[11]	T. Montrief, B. Long, A. Koyfman and J. Auerbach, "Fournier Gangrene: A Review for Emergency Clinicians", The Journal of Emergency Medicine, vol. 57, no. 4, pp. 488-500, 2019. Available: 10.1016/j.jemermed.2019.06.023.
[12]	J. Sparenborg, J. Brems, A. Wood, J. Hwang and K. Venkatesan, "Fournier’s gangrene: a modern analysis of predictors of outcomes", Translational Andrology and Urology, vol. 8, no. 4, pp. 374-378, 2019. Available: 10.21037/tau.2019.03.09.
[13]	A. Singh, K. Ahmed, A. Aydin, M. S. Khan, and P. Dasgupta, “Fournier’s gangrene. A clinical review,” Arch. Ital. Urol. Androl., vol. 88, no. 3, pp. 157–164, 2016.
[14]	G. Gerber, S. Guss and R. Pielet, "Fournier's gangrene secondary to intra-abdominal processes", Urology, vol. 44, no. 5, pp. 779-782, 1994. Available: 10.1016/s0090-4295(94)80230-0.
[15]	I. Elahabadi, G. Bazmandegan, H. Salehi, A. Jafari, J. Ahmadi and Z. Kamaib, "Fournier's gangrene after missed acute perforated appendicitis: A case report", Clinical Case Reports, vol. 9, no. 10, 2021. Available: 10.1002/ccr3.4989.

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APA Style

Mustafa Abdullah Abbas, Maryam Tawfiq Aburezq, Amal Hassan Elsabbagh. (2022). Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report. Journal of Surgery, 10(1), 8-14. https://doi.org/10.11648/j.js.20221001.13

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ACS Style

Mustafa Abdullah Abbas; Maryam Tawfiq Aburezq; Amal Hassan Elsabbagh. Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report. J. Surg. 2022, 10(1), 8-14. doi: 10.11648/j.js.20221001.13

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AMA Style

Mustafa Abdullah Abbas, Maryam Tawfiq Aburezq, Amal Hassan Elsabbagh. Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report. J Surg. 2022;10(1):8-14. doi: 10.11648/j.js.20221001.13

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@article{10.11648/j.js.20221001.13,
  author = {Mustafa Abdullah Abbas and Maryam Tawfiq Aburezq and Amal Hassan Elsabbagh},
  title = {Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {8-14},
  doi = {10.11648/j.js.20221001.13},
  url = {https://doi.org/10.11648/j.js.20221001.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.13},
  abstract = {Fournier’s gangrene and retroperitoneal abscess are rare complications of late presentation of perforated acute appendicitis. This case report discusses the case of a 46-year-old male patient who presented with 5 days history of progressive abdominal pain and was admitted to our department as a case of complicated perforated acute appendicitis followed by retroperitoneal abscess formation and Fournier’s Gangrene few days later. The patient had a hospital stay of 53 days, during which he underwent diagnostic laparoscopy and appendectomy, computerized tomography guided percutaneous abscess incision and drainage for the retroperitoneal abscess and multiple scrotal debridement surgeries for the Fournier’s gangrene, in addition to the drain care and intravenous antibiotic course he received. Diabetes mellitus is one of the most common risk factors of Fournier’s gangrene, which was newly detected in our patient six months earlier. Fournier’s gangrene is ten times more common in males than in females, especially in their third and sixth decade of life. It is life-threatening and has unfavorable prognosis that indicates early detection and aggressive surgical and medical intervention with a multidisciplinary approach, including fluid resuscitation, immediate initiation of broad-spectrum antibiotics and aggressive debridement of the necrotic tissue; in addition to the respiratory and hemodynamic support to improve the prognosis and overall outcome and to maximize the chances of survival.},
 year = {2022}
}

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TY  - JOUR
T1  - Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report
AU  - Mustafa Abdullah Abbas
AU  - Maryam Tawfiq Aburezq
AU  - Amal Hassan Elsabbagh
Y1  - 2022/01/20
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221001.13
DO  - 10.11648/j.js.20221001.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 8
EP  - 14
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221001.13
AB  - Fournier’s gangrene and retroperitoneal abscess are rare complications of late presentation of perforated acute appendicitis. This case report discusses the case of a 46-year-old male patient who presented with 5 days history of progressive abdominal pain and was admitted to our department as a case of complicated perforated acute appendicitis followed by retroperitoneal abscess formation and Fournier’s Gangrene few days later. The patient had a hospital stay of 53 days, during which he underwent diagnostic laparoscopy and appendectomy, computerized tomography guided percutaneous abscess incision and drainage for the retroperitoneal abscess and multiple scrotal debridement surgeries for the Fournier’s gangrene, in addition to the drain care and intravenous antibiotic course he received. Diabetes mellitus is one of the most common risk factors of Fournier’s gangrene, which was newly detected in our patient six months earlier. Fournier’s gangrene is ten times more common in males than in females, especially in their third and sixth decade of life. It is life-threatening and has unfavorable prognosis that indicates early detection and aggressive surgical and medical intervention with a multidisciplinary approach, including fluid resuscitation, immediate initiation of broad-spectrum antibiotics and aggressive debridement of the necrotic tissue; in addition to the respiratory and hemodynamic support to improve the prognosis and overall outcome and to maximize the chances of survival.
VL  - 10
IS  - 1
ER  -

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Author Information

Mustafa Abdullah Abbas

Department of Surgery, Farwanyia Hospital, Ministry of Health, Farwanyia Governorate, Kuwait
Maryam Tawfiq Aburezq

Department of Surgery, Farwanyia Hospital, Ministry of Health, Farwanyia Governorate, Kuwait
Amal Hassan Elsabbagh

Department of Radiology, Farwanyia Hospital, Ministry of Health, Farwanyia Governorate, Kuwait

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APA Style

Mustafa Abdullah Abbas, Maryam Tawfiq Aburezq, Amal Hassan Elsabbagh. (2022). Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report. Journal of Surgery, 10(1), 8-14. https://doi.org/10.11648/j.js.20221001.13

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ACS Style

Mustafa Abdullah Abbas; Maryam Tawfiq Aburezq; Amal Hassan Elsabbagh. Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report. J. Surg. 2022, 10(1), 8-14. doi: 10.11648/j.js.20221001.13

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AMA Style

Mustafa Abdullah Abbas, Maryam Tawfiq Aburezq, Amal Hassan Elsabbagh. Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report. J Surg. 2022;10(1):8-14. doi: 10.11648/j.js.20221001.13

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@article{10.11648/j.js.20221001.13,
  author = {Mustafa Abdullah Abbas and Maryam Tawfiq Aburezq and Amal Hassan Elsabbagh},
  title = {Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {8-14},
  doi = {10.11648/j.js.20221001.13},
  url = {https://doi.org/10.11648/j.js.20221001.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.13},
  abstract = {Fournier’s gangrene and retroperitoneal abscess are rare complications of late presentation of perforated acute appendicitis. This case report discusses the case of a 46-year-old male patient who presented with 5 days history of progressive abdominal pain and was admitted to our department as a case of complicated perforated acute appendicitis followed by retroperitoneal abscess formation and Fournier’s Gangrene few days later. The patient had a hospital stay of 53 days, during which he underwent diagnostic laparoscopy and appendectomy, computerized tomography guided percutaneous abscess incision and drainage for the retroperitoneal abscess and multiple scrotal debridement surgeries for the Fournier’s gangrene, in addition to the drain care and intravenous antibiotic course he received. Diabetes mellitus is one of the most common risk factors of Fournier’s gangrene, which was newly detected in our patient six months earlier. Fournier’s gangrene is ten times more common in males than in females, especially in their third and sixth decade of life. It is life-threatening and has unfavorable prognosis that indicates early detection and aggressive surgical and medical intervention with a multidisciplinary approach, including fluid resuscitation, immediate initiation of broad-spectrum antibiotics and aggressive debridement of the necrotic tissue; in addition to the respiratory and hemodynamic support to improve the prognosis and overall outcome and to maximize the chances of survival.},
 year = {2022}
}

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TY  - JOUR
T1  - Fournier Gangrene and Retroperitoneal Abscess Secondary to Perforated Appendicitis: A Case Report
AU  - Mustafa Abdullah Abbas
AU  - Maryam Tawfiq Aburezq
AU  - Amal Hassan Elsabbagh
Y1  - 2022/01/20
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221001.13
DO  - 10.11648/j.js.20221001.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 8
EP  - 14
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221001.13
AB  - Fournier’s gangrene and retroperitoneal abscess are rare complications of late presentation of perforated acute appendicitis. This case report discusses the case of a 46-year-old male patient who presented with 5 days history of progressive abdominal pain and was admitted to our department as a case of complicated perforated acute appendicitis followed by retroperitoneal abscess formation and Fournier’s Gangrene few days later. The patient had a hospital stay of 53 days, during which he underwent diagnostic laparoscopy and appendectomy, computerized tomography guided percutaneous abscess incision and drainage for the retroperitoneal abscess and multiple scrotal debridement surgeries for the Fournier’s gangrene, in addition to the drain care and intravenous antibiotic course he received. Diabetes mellitus is one of the most common risk factors of Fournier’s gangrene, which was newly detected in our patient six months earlier. Fournier’s gangrene is ten times more common in males than in females, especially in their third and sixth decade of life. It is life-threatening and has unfavorable prognosis that indicates early detection and aggressive surgical and medical intervention with a multidisciplinary approach, including fluid resuscitation, immediate initiation of broad-spectrum antibiotics and aggressive debridement of the necrotic tissue; in addition to the respiratory and hemodynamic support to improve the prognosis and overall outcome and to maximize the chances of survival.
VL  - 10
IS  - 1
ER  -

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