title: Perforated duodenum--an unusual etiology of Fournier's disease: a case report.
abstract: Fournier's disease, a form of necrotizing fasciitis, is a rapidly progressing subcutaneous infection of the male genitalia. We report a case of Fournier's disease with the unusual etiology of a perforated duodenum. This patient suffered from progressive right scrotal swelling after percutaneous transhepatic cholangeal drainage. Scrotal exploration revealed a large abscess with muscle necrosis that had spread up to the right retroperitoneal space. Radiologic studies and second abdominal exploration documented the origin as a perforated duodenum. The pus distribution in this case suggested that the infection process differed from that in previous reports. In future cases of Fournier's disease involving previous abdominal events, we recommend that abdominal origins be carefully surveyed before scrotal exploration.
authors.affiliation: Department of Urology, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yung-Chin
authors.initials: YC
authors.lastname: Lee
authors.forename: Wen-Horng
authors.initials: WH
authors.lastname: Yang
authors.forename: Wen-Jeng
authors.initials: WJ
authors.lastname: Wu
authors.forename: Yii-Her
authors.initials: YH
authors.lastname: Chou
authors.forename: Chun-Hsiung
authors.initials: CH
authors.lastname: Huang
mesh_terms: D000368:Aged; D004378:Duodenal Diseases / Q000150:complications*; D018934:Fournier Gangrene / Q000209:etiology*; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications*; D008297:Male