Fournier gangrene - spontaneous perforation of rectal cancer
Spontaneous swelling and cellulitis in right thigh and perineum. Septic. Known case of rectal cancer.
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Gas arising in the pelvis near the rectum passing into the peri-rectal, ischioanal and ischiorectal fossae, and then into the buttock, posterior right thigh and perineum, extending into the right scrotum. Note right sided sacral body lytic metastasis consistent with known low rectal carcinoma.
This is a medical emergency as the patients are often hypotensive if gas-forming organisms are responsible and there may be large areas of necrotic soft tissue that needs surgical debridement to avoid progression. Patients are often diabetic so mention this possibility in the report and stress the seriousness of the condition