title: Fournier's gangrene after Milligan-Morgan hemorrhoidectomy requiring subsequent abdominoperineal resection of the rectum: report of a case.
abstract: The development of Fournier's gangrene after Milligan-Morgan hemorrhoidectomy of a previously healthy 76-year-old female patient is described. After such a common surgical procedure, the patient developed full-thickness skin necrosis of the perianal region including the rectum. Immediate radical debridement was mandatory. Because of rectal involvement, a diverting sigmoid colostomy was required. The rectum had to be removed by abdominoperineal resection. This disastrous complication was completely unexpected and unpredictable after Milligan-Morgan hemorrhoidectomy because of the lack of predisposing factors.
authors.affiliation: Department of Plastic Surgery, Burn Center, Handsurgery, Sarcoma Reference Center, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany marcus.lehnhardt@rub.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: Lars
authors.initials: L
authors.lastname: Steinstraesser
authors.forename: Daniel
authors.initials: D
authors.lastname: Druecke
authors.forename: Thomas
authors.initials: T
authors.lastname: Muehlberger
authors.forename: Hans U
authors.initials: HU
authors.lastname: Steinau
authors.forename: Heinz H
authors.initials: HH
authors.lastname: Homann
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000473:pathology; D000714:Anastomosis, Surgical; D003125:Colostomy; D003646:Debridement; D005260:Female; D018934:Fournier Gangrene / Q000209:etiology* / Q000473:pathology; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D009336:Necrosis; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection