Fournier-Gangrän als seltene Komplikation nach Staplerhämorrhoidektomie Kasuistik und Literaturübersicht

Bönner, Ch.; Prohm, P.; Störkel, S.

doi:10.1007/s001040170012

Cited by 46 publications

(7 citation statements)

References 4 publications

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“…Only eight cases of FG have previously been reported after hemorrhoidectomy [5, 15, 16, 17, 18, 19, 20, 21]. This case is the second description of unforeseeable and unpredictable FG development after open hemorrhoidectomy in a patient otherwise healthy without a predisposing factor.…”

Section: Introductionmentioning

confidence: 81%

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

Çakmak

İrkörücü²,

Uçan³

et al. 2009

Case Rep Gastroenterol

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Fournier’s gangrene (FG) is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in men and vulva in women. An unpredictable case of FG two weeks after open hemorrhoidectomy in a previously healthy 55-year-old male is described. Full-thickness patchy skin necrosis of the perianal, perineal and scrotal region associated with rectal perforation was detected on admission. Prompt radical debridement together with aggressive fluid resuscitation and broad-spectrum antibiotic administration was initiated. Because of rectal involvement, diverting sigmoid colostomy was fashioned. The patient survived after two additional local debridements. Nevertheless, loss of sphincter function due to massive muscle destruction led to permanent colostomy. Our case together with others reported in the literature illustrates that, although rare, FG after open hemorrhoidectomy represents a life-threatening complication to otherwise healthy patients. The development of fever and urinary retention should draw the attention of the surgeon, even if the presentation is delayed. The current literature only briefly mentions the potential risk of FG after such a common surgical procedure. However, devastating complications occur more often than anticipated. This disastrous complication without predisposing factor is discussed along with a literature review.

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Section: Introductionmentioning

confidence: 81%

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

Çakmak

İrkörücü²,

Uçan³

et al. 2009

Case Rep Gastroenterol

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“…Predisposing factors include diabetes because of microangiopathy and polyneuropathy, alcoholism, immune-defects, and consumptive diseases [13]. …”

Section: Discussionmentioning

confidence: 99%

A case of Fournier’s gangrene after hydrocelectomy

2012

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An uncommon case of Fournier's gangrene following hydrocelectomy is described. A 78-year-old male with no remarkable previous history, who underwent hydrocelectomy in another hospital, developed Fournier's gangrene 15 days later. The patient required wide aggressive surgical debridement, hyperbaric oxygen chamber and broad-spectrum antibiotic coverage. Afterwards the patient was referred for plastic surgery. Fournier's gangrene is a polymicrobial infection of perineoscrotal region that manifests as a rapidly progressive necrotizing fasciitis. Fournier's gangrene following hydrocelectomy is uncommon. The morbidity and mortality in this severe complication depend on early diagnosis and aggressive surgical management.

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“…The operation is defined as ‘easy’ by some authors [27] whereas for a few others it was ‘demanding’ [26]. Rates of complications after SH range from 6 to 31% [18,27,28,29], and surprisingly, complications reported after SH are similar to those of open hemorrhoidectomy and, in addition, other complications like hemorrhoidal thrombosis [30], rectal anastomotic leakages with pelvic sepsis, rectal obstruction, retrorectal hematomas, rectal perforation [31], retroperitoneal sepsis [32], Fournier gangrene [33], proctitis [34], fecal peritonitis [35] and anemia due to bleeding from seam insufficiency [36] have also been reported. Such complications were not encountered in any of the patients treated with our technique of hemorrhoidal ablation and fixation.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

Gupta¹

2005

Digestion

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Background: Many new techniques have been evolved to curb the problem of post-operative pain after hemorrhoidectomy. Stapler hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation are the two methods gaining popularity amongst proctologists. The author proposes another technique called radiofrequency ablation and fixation of hemorrhoids to add to this list. Patients and Methods: The surgical technique and clinical follow-up of 410 patients operated by this technique are presented. An Ellman radiofrequency generator was used for hemorrhoidal ablation at the output power intensity of 80. Post-defecation pain and pain at rest were assessed using a visual analogue scale. Patient satisfaction score was calculated at the mean follow-up of 60 months (range 48–72). The results in terms of mean hospital stay, post-operative pain, post-operative complications, and period of incapacity for work were compared with the published data of results of stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. Results: Pain score at first evacuation was 6. The post-defecation pain score in the first week was 4 (range 3–6) and it was 3 (range 2–5) in the second week. The mean pain score at rest in the first week was 2 (range 1–4) and 1 (range 0–2) in the second post-operative week. In the long-term follow-up at a mean of 60 months, this procedure was found in most of the cases to control prolapse, discharge, and bleeding, with no stenosis or incontinence. The recurrence rate was less than 2%. The patient satisfaction score was high. Conclusion: The results of this technique of radiofrequency ablation and fixation of hemorrhoids hold positive promises in terms of less post-operative pain, early discharge from the hospital and faster return to work. The results are comparable to stapled hemorrhoidopexy and are better than Doppler-guided hemorrhoidal artery ligation in terms of effectiveness and symptomatic relief on a long-term basis.

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Fournier-Gangrän als seltene Komplikation nach Staplerhämorrhoidektomie Kasuistik und Literaturübersicht

Cited by 46 publications

References 4 publications

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

A case of Fournier’s gangrene after hydrocelectomy

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

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Fournier-Gangrän als seltene Komplikation nach Staplerhämorrhoidektomie Kasuistik und Literaturübersicht

Cited by 46 publications

References 4 publications

Fournier&rsquo;s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

Fournier&rsquo;s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

A case of Fournier’s gangrene after hydrocelectomy

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

Contact Info

Product

Resources

About

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature