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GENITOPERINEAL GANGRENE: EXPERIENCE IN SINGAPORE
Author(s) -
Ong Hock Soo,
Ho Yik Hong
Publication year - 1996
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1996.tb01188.x
Subject(s) - medicine , gangrene , sepsis , confusion , surgery , diabetes mellitus , malignancy , colostomy , presentation (obstetrics) , general surgery , psychology , psychoanalysis , endocrinology
Background: The experience with genitoperineal gangrene at the Department of Colorectal Surgery, Singapore General Hospital is documented. Methods: The results of 12 patients treated during the 5 year period between 1 January 1990 and 31 January 1995 were studied. There were 10 men and two women. The mean age of the patients was 55.2 (range 37–83) years. Results: Perianal pain and swelling were the commonest presentation. However, three patients were admitted in a toxic state with mental confusion. The gangrene progressed from anorectal sepsis in six patients. Five of these patients had diabetes mellitus. Escherichia coli was the commonest organism cultured. Early diagnosis, immediate resuscitation, antibiotics and early aggressive surgery was our management policy. Applying these principles, all except two patients survived (mortality 17%). One had advanced malignacy and the other had extensive hum injuries. Conclusions: A high index of suspicion should he maintained in patients with diabetes and with anorectal sepsis. Should genitoperineal gangrene develop, aggressive surgery is often successful.