Rectal cancer and Fournier's gangrene - current knowledge and therapeutic options

Bruketa, Tomislav and Majerović, Matea and Augustin, Goran (2015) Rectal cancer and Fournier's gangrene - current knowledge and therapeutic options. World Journal of Gastroenterology, 21 (30). pp. 9002-9020. ISSN 1007-9327

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Official URL: https://doi.org/10.3748/wjg.v21.i30.9002

Abstract

Fournier's gangrene (FG) is a rapid progressive bacterial infection that involves the subcutaneous fascia and part of the deep fascia but spares the muscle in the scrotal, perianal and perineal region. The incidence has increased dramatically, while the reported incidence of rectal cancer-induced FG is unknown but is extremely low. Pathophysiology and clinical presentation of rectal cancer-induced FG per se does not differ from the other causes. Only rectal cancer-specific symptoms before presentation can lead to the diagnosis. The diagnosis of rectal cancer-induced FG should be excluded in every patient with blood on digital rectal examination, when urogenital and dermatological causes are excluded and when fever or sepsis of unknown origin is present with perianal symptomatology. Therapeutic options are more complex than for other forms of FG. First, the causative rectal tumor should be removed. The survival of patients with rectal cancer resection is reported as 100%, while with colostomy it is 80%. The preferred method of rectal resection has not been defined. Second, oncological treatment should be administered but the timing should be adjusted to the resolution of the FG and sometimes for the healing of plastic reconstructive procedures that are commonly needed for the reconstruction of large perineal, scrotal and lower abdominal wall defects.

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Article

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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/

MeSH:

Anti-Bacterial Agents/therapeutic use ; Chemoradiotherapy, Adjuvant ; Colostomy ; Diagnosis, Differential ; Digestive System Surgical Procedures ; Fournier Gangrene/diagnosis ; Fournier Gangrene/epidemiology ; Fournier Gangrene/microbiology ; Fournier Gangrene/surgery ; Humans ; Incidence ; Predictive Value of Tests ; Reconstructive Surgical Procedures ; Rectal Neoplasms/diagnosis ; Rectal Neoplasms/epidemiology ; Rectal Neoplasms/surgery ; Risk Factors ; Treatment Outcome

Departments:

Katedra za kirurgiju

Depositing User:

Martina Žužak

Status:

Published

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