PERINEAL GANGRENE: AN EXPERIENCE OF DIGESTIVE AND PROCTOLOGIC SURGICAL UNIT, UNIVERSITY HOSPITAL OF TREICHVILLE

Abstract

Background: Perineal gangrene is a serious and relatively frequent disease in Africa and particularly in Côte d’Ivoire. The aim of this study was to show etiology, presentation, and management in developing country. Material & Methods: This retrospective study was carried over a period of nine years from January 2004 to December 2012 at University Hospital of Treichville. The sex, age, etiology, presentation, risk factors and management were studied. Chi 2 test was applied with a sensibility of 5%. Results: Thirty-one patients were studied. The patients’ mean age was 45 years with a male predominance (27 men for 4 women). Alcoholic intoxication was noted in 14 cases, diabetes in 4, HIV disease in 2 and cardiomyopathy in 1. An etiology was identified in 20 patients, dominated by the anal fistula (n=10). The average time of consultation was 12 days. All patients were seen at the stage of gangrene which was extended to the nearby areas in 5 cases. The reanimation, the excision of necrotic tissues and the antibiotherapy constituted the essence of treatment. Daily dressings after sit bath in Dakin were associated. No colostomy was carried out. The mortality was 22.6% (n=7). The presence of shock and high serum creatinine were bad prognostic signs. Conclusion: Perineal gangrene is a serious disease that affects adult males more frequently. It may arise from traumatic lesion or infections of perineal area. Delayed presentation is a common feature of advanced lesions. An early consultation in all perineal nuisances whatever their origin, might prevent and improve the prognosis.

Keywords

• perineum, gangrene, perineal gangrene
• fournier gangrene, necrotizing fasciitis.