Fournier’s gangrene in voluminous inguinoscrotal herniation: Case report and review of literature

Introduction: Fournier’s gangrene (FG) is a polymicrobial life-threatening infection that affects perineal region and may extend to genitalia and abdominal wall. Necrotizing fasciitis is a rare condition and its association with large inguinoscrotal hernia even rarer. With high mortality rate, some predisposing factors are diabetes and immunodeficiency. Case presentation: We report a case of a 48-year-old man with Fournier’s gangrene associated with voluminous inguinoscrotal herniation which evolved to hernia sac exposure after debridement. Discussion: FG pathophysiology initiates with a localized infection by a combination of gram positive, gram negative and anaerobic bacteria, and its advancing leads to local inflammatory response, thrombosis, blood flow reduction and ischemia. Diagnosis depends on clinical presentation and image evaluation. Conclusion: FG management has been standard in the literature, however its association with inguinoscrotal hernias have not been considered in guidelines. Early diagnosis and proper clinical and surgical treatment are fundamental to avoid life-threatening complications and morbidities.