Perineal gangrene in the patient with granulocytopenia: the importance of early diverting colostomy.
Perirectal and perineal infections represent a life-threatening complication of hematologic diseases associated with granulocytopenia. Early and aggressive surgical management is essential. This should include hemodynamic support and monitoring, broad-spectrum antibiotics, wide surgical debridement, and a totally diverting colostomy. The prognosis of these infections parallels that of the underlying hematologic disease. Three patients seen on a university surgical service whose clinical management and course underscore these principles are presented.
D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis / Q000150:complications*; D003125:Colostomy; D005734:Gangrene; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000473:pathology*; D012002:Rectal Diseases / Q000209:etiology* / Q000601:surgery