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Fournier's gangrene secondary to an acutely inflamed appendix herniating into the deep inguinal ring.

Sarmah PB, Khan M, Zilvetti M - J Surg Case Rep (2015)

Bottom Line: Histological analysis demonstrated acute-on-chronic inflammation involving the appendix.The condition where appendicitis is implicated in FG is usually due to retroperitoneal rupture and tracking into the perineal spaces.This is the first case reported of an inflamed appendix herniating into the inguinal canal and thus causing FG.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Urology, City Hospital, Birmingham, UK piyushbsarmah@doctors.org.uk.

No MeSH data available.


Related in: MedlinePlus

Coronal section CT image demonstrating extension of the loculated air superiorly into the inguinal canal and lower anterior abdominal wall and laterally into the right buttock. There is also a 10 × 4 × 6 cm fluid and air collection in the right pelvis.
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RJV027F2: Coronal section CT image demonstrating extension of the loculated air superiorly into the inguinal canal and lower anterior abdominal wall and laterally into the right buttock. There is also a 10 × 4 × 6 cm fluid and air collection in the right pelvis.

Mentions: Blood tests showed grossly elevated white cell count and acute kidney injury, along with markedly deranged clotting parameters (Table 1). The patient was resuscitated with further intravenous fluids, and broad-spectrum antibiotics were commenced. Prothrombin complex concentrate was administered to correct the international normalized ratio. En route to theatre for surgical debridement the patient underwent computed tomography (CT) to assess for intra-abdominal sepsis, given the clinical findings of lower abdominal peritonism and the recent reported lower abdominal pain. This revealed a large amount of loculated gas mainly within the right hemiscrotum with superior extension into the inguinal canal, lower anterior abdominal wall and subcutaneous soft tissue, and lateral extension towards the right buttock; along the right lateral pelvic wall, there was a 10 × 4 × 6 cm collection containing fluid and air. No bowel loops were identified extending into the inguinal region (Figs 1 and 2).Table 1


Fournier's gangrene secondary to an acutely inflamed appendix herniating into the deep inguinal ring.

Sarmah PB, Khan M, Zilvetti M - J Surg Case Rep (2015)

Coronal section CT image demonstrating extension of the loculated air superiorly into the inguinal canal and lower anterior abdominal wall and laterally into the right buttock. There is also a 10 × 4 × 6 cm fluid and air collection in the right pelvis.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4379731&req=5

RJV027F2: Coronal section CT image demonstrating extension of the loculated air superiorly into the inguinal canal and lower anterior abdominal wall and laterally into the right buttock. There is also a 10 × 4 × 6 cm fluid and air collection in the right pelvis.
Mentions: Blood tests showed grossly elevated white cell count and acute kidney injury, along with markedly deranged clotting parameters (Table 1). The patient was resuscitated with further intravenous fluids, and broad-spectrum antibiotics were commenced. Prothrombin complex concentrate was administered to correct the international normalized ratio. En route to theatre for surgical debridement the patient underwent computed tomography (CT) to assess for intra-abdominal sepsis, given the clinical findings of lower abdominal peritonism and the recent reported lower abdominal pain. This revealed a large amount of loculated gas mainly within the right hemiscrotum with superior extension into the inguinal canal, lower anterior abdominal wall and subcutaneous soft tissue, and lateral extension towards the right buttock; along the right lateral pelvic wall, there was a 10 × 4 × 6 cm collection containing fluid and air. No bowel loops were identified extending into the inguinal region (Figs 1 and 2).Table 1

Bottom Line: Histological analysis demonstrated acute-on-chronic inflammation involving the appendix.The condition where appendicitis is implicated in FG is usually due to retroperitoneal rupture and tracking into the perineal spaces.This is the first case reported of an inflamed appendix herniating into the inguinal canal and thus causing FG.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Urology, City Hospital, Birmingham, UK piyushbsarmah@doctors.org.uk.

No MeSH data available.


Related in: MedlinePlus