Rectocutaneous fistula with Fournier's gangrene, a rare presentation of rectal cancer

Abstract

Figure 1 CT demonstrating a large rectal tumour (A) with gross evasion of the perianal tissues, extension into the vagina and subcutaneous tissue bilaterally and a large volume of air in the tissues (B).

Locally advanced adenocarcinoma of the rectum presenting with necrotising fasciitis of the perineum: successful management with early aggressive surgery and multimodal therapy

“…Since necrotising fasciitis is more common in elderly and immunocompromised patients, and carries high mortality,4 7 and because rectal cancer is usually in the perforated stage, aggressive curative-intent therapy is often not possible 9 13 15. The case we present illustrates the need for immediate life-saving control of local sepsis (wide debridement and faecal diversion), followed by vacuum-assisted closure.…”

Fournier’s Gangrene in the Setting of Underlying Carcinoma: A Case Report and Review of the Literature

“…Infections are often polymicrobial and may contain anaerobe pathogens. The infection further promotes local tissue destruction and micro-thrombosis of surrounding blood vessels [8]. Bacteria that possess certain tissue-spreading factors, may spread along with fatty tissue and fascial planes, leading to progressive cellulitis and potentially necrotizing fasciitis [8].…”

“…Tissue histopathology is considered the golden standard to confirm the diagnosis of FG and distinguish the disease from other forms of soft tissue infection. Histologic evaluation of the involved tissues reveals widespread necrosis of superficial and deep soft tissues and fascia, fibrinoid microvascular thrombosis of small and intermediate vessels, polymorphic cell infiltration, and necrotic detritus [8,13]. Surgeons should obtain tissue biopsies from various depths of the affected areas in all FG patients during exploration and debridement, to confirm the diagnosis and identify a potentially associated malignancy [14].…”

Management of Patients with Locally Advanced Rectal Cancer with Purulent-Inflammatory Complications and the Presence of Fistula

“…Такое осложнение может проявиться при метастатическом поражении промежности на фоне новообразования толстой кишки [7]. В ряде случаев формирование свищевого хода может повлечь за собой ухудшение состояния пациента за счет присоединения новых осложнений, таких как гангрена Фурнье, парапроктит, забрюшинная флегмона, что делает невозможным противоопухолевое лечение [8]. [9,10].…”