老年男性的 Fournier 坏疽:两个病例的报告。

IF 0.6 Q4 SURGERY International Journal of Surgery Case Reports Pub Date : 2025-01-01 Epub Date: 2024-12-10 DOI:10.1016/j.ijscr.2024.110734
Suchit Thapa Chhetri, Sumit Kumar Sah, Indra Dev Pathak, Niraaz Pokhrel, Prem Khadka Thyayat, Nitesh Kumar Shah
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引用次数: 0

摘要

导言:福尼尔坏疽是一种影响阴囊和会阴部位的多菌感染,主要影响老年男性,给诊断和治疗带来了挑战。本报告探讨了两个病例,重点是双侧睾丸切除术的罕见结果:病例介绍:一名 69 岁的男性糖尿病患者出现严重的阴茎和阴囊疼痛,被诊断为福尼尔坏疽。在另一个病例中,一名 91 岁的男性患有良性前列腺增生,出现阴囊疼痛和溃疡性病变,导致坏疽迅速发展。手术方法包括多次清创和双侧睾丸切除术,凸显了治疗福尼尔坏疽的复杂性:讨论:福尼尔坏疽通常起源于泌尿生殖系统或肛周的多菌感染,常见的危险因素包括糖尿病、免疫抑制和高龄。诊断通常依靠临床评估,但复杂病例可借助影像学检查。使用广谱抗生素和反复清创进行早期干预仍是治疗的基础:结论:福尼尔坏疽是一种罕见疾病,其临床表现、治疗策略和结果多种多样。早期识别、积极手术清创和多学科方法对于治疗这种疾病至关重要。
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Fournier's gangrene in elderly men: A report of two cases.

Introduction: Fournier's gangrene, a polymicrobial infection affecting the scrotum and perineal area, predominantly affects elderly males, presenting challenges in diagnosis and management. This report examines two cases, with a focus on the rare outcome of bilateral orchidectomy.

Case presentation: A 69-year-old diabetic male presented with severe penile and scrotal pain, leading to the diagnosis of Fournier's gangrene. In another case, a 91-year-old male with a history of Benign Enlargement of the Prostate experienced scrotal pain and ulcerative lesions, resulting in a rapid progression of gangrene. The surgical approaches encompassed multiple debridement and bilateral orchidectomy, underscoring the intricate nature of managing Fournier's gangrene.

Discussion: Fournier's gangrene typically originates as a polymicrobial infection in the genitourinary or perianal regions, with common risk factors including diabetes, immunosuppression, and advanced age. Diagnosis often relies on clinical assessment, though imaging aids in complex cases. Early intervention with broad-spectrum antibiotics and repeated debridement remains the cornerstone of treatment.

Conclusion: Fournier's gangrene, a rare condition, poses diverse clinical presentations, management strategies, and outcomes. Early recognition, aggressive surgical debridement, and a multidisciplinary approach are essential in managing this condition.

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CiteScore
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发文量
1116
审稿时长
46 days
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