フルニエ壊疽の1例

A CASE OF FOURNIER'S GANGRENE

　脊髄損傷にて下半身麻痺となり，自己導尿していた38歳の男性が意識障害にて緊急入院した。臨床所見と画像診断よりフルニエ壊疽および腎後性腎不全と診断し，全身麻酔下に両側腎瘻造設および下腹部から会陰部にかけて切開排膿および洗浄を施行した。本症例においては糖尿病および脊髄損傷後の下半身麻痺が発症の誘因となっていることが示唆された。

A 38-year-old male with abdominal and scrotal gangrene was admitted to our hospital because of the disturbance of his consciousness. Medical history was significant for neurogenic bladder with paraplasia secondary to spinal cord injury 7 years previously, treated with intermittent selfcatheterization. Based on clinical and radiological findings, the diagnosis of Fournier's gangrene and post-renal renal failure was made. Under general anesthesia, bilateral percutaneous nephrostomy was made and multiple incisions and drainage of the gangrene were performed.