Title
Fournier gangrene: role of imaging
PubMed ID
18349455
UMMS Affiliation
Department of Radiology
Date
3-20-2008
Document Type
Article
Subjects
Diagnosis, Differential; Early Diagnosis; Fournier Gangrene; Humans; Risk Factors; *Tomography, X-Ray Computed
Disciplines
Life Sciences | Medicine and Health Sciences
Abstract
Fournier gangrene is a rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with a potentially high mortality rate. Although the diagnosis of Fournier gangrene is often made clinically, emergency computed tomography (CT) can lead to early diagnosis with accurate assessment of disease extent. CT not only helps evaluate the perineal structures that can become involved by Fournier gangrene, but also helps assess the retroperitoneum, to which the disease can spread. Findings at CT include asymmetric fascial thickening, subcutaneous emphysema, fluid collections, and abscess formation. Subcutaneous emphysema is the hallmark of Fournier gangrene but is not seen in all cases. Compared with radiography and ultrasonography, CT provides a higher specificity for the diagnosis of Fournier gangrene and superior evaluation of disease extent; however, diagnosis and evaluation can also be performed with these other modalities. The administration of broad-spectrum antibiotics and aggressive surgical debridement of the nonviable tissue are both essential for successful treatment. An awareness of the CT features of Fournier gangrene is imperative for prompt diagnosis and effective treatment planning.
Rights and Permissions
Citation: Radiographics. 2008 Mar-Apr;28(2):519-28. Link to article on publisher's site
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