Manzanilla SM

Language: Spanish
References: 30
Page: 6-14
PDF size: 337.87 Kb.

ABSTRACT

Jean Alfred Fournier, first described in 1883 a polymicrobial necrotizing fascitis of the perineal, perirectal or genital area, as an idiopathic condition of the scrotum. The disease now differs from the original description and is now realized to be associated or secondary to numerous pathologies and surgical procedures. We present 12 cases with cutaneous manifestations of bulknes, abscess or fistulae, in which computed tomography (CT), demonstrated extensions to: Perine/scrotum (5-12), Thigh/obturator (2-12), Inguinal/spermatic (2-12), Gluteus/piriformis (1-12), Abdominal-fascia transversa and square fascia (1-12) arid psoas, lumbodorsal fascia, pleura parietal, interne intercostal (1-12). The spreading patterns were explained by the fascial anatomy of the pelvis, perineum, abdomen and thorax. TC imaging modalities demonstrated utility in confirming the disease, evaluating extent, determining the etiology and planning surgical treatment. Surgical management consisted in drainage, necrectomy, fasciectomy, and Penrose drains, along with antibiotics and supportive measures. With the exception of one dead in the case of diabetic/septisemic elder patient who´s show thoracic fistula and two perineal fistulae with spontaneous closure in 8 to 12 months, favorable evolution was registered. In addition to traditional clinical signs, bulknes, abscess or fistulae, improved diagnosis and extensions, necrosectomies and drainages.

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