Gangrène périnéoscrotale : à propos de 51 cas. Aspects diagnostiques et thérapeutiques

Abstract

Objective – To approach the treatement of Fournier's gangrene. So, pathophysiology and etiology are recallled. Methods – The authors present 51 cases of Fournier's gangrene treated from 1989 to 1998, their age ranged from 19 to 89 years. Data were collected on admission signs and symptoms, physical examination. Aggressive surgical debridement of all necrotic tissues was performed, Intravenous antibiotics and resuscitation fluid were also administered. Results – All patients were male. In 20 cases (39%), there was no identifiable cause, and in 31 cases (61%), the etiology of gangrene was urethral (33%), anorectal (28%) and unknown (19%). The average hospital stay was 30 days. Three cases underwent unilateral orchidectomy, six colostomy and in 17 cases, a suprapubic catheter was inserted. Mortality was high (18%) and essentially associated to debilated state and toxi-infectious context. Conclusion – Fournier's gangrene is a true urolologic emergency potential lethal, wich requires aggressive antibiotic and surgical treatement.