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Congress: ECR25
Poster Number: C-16159
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-16159
Authorblock: D. M. Axani; Suceava/RO
Disclosures:
Diana Maria Axani: Nothing to disclose
Keywords: Genital / Reproductive system male, CT, Contrast agent-intravenous, Abscess, Fistula, Infection
Learning objectives 1.To remind radiologists of the importance of imaging in the detection of gangrene Fournier2.To outline the main radiological findings using CT scan in this rare and life-threatening bacterial infection.
Read more Background Fournier’s gangrene is a rapidly progressing, life-threatening infection that primarily affects the perineum, scrotum, and penis. It is a form of necrotizing fasciitis caused by a polymicrobial mix of bacteria, which leads to tissue necrosis. These bacteria thrive in low-oxygen environments with limited blood flow, accelerating tissue breakdown. The resulting obliterated endarteritis, with vascular thrombosis, causes subcutaneous tissue necrosis and gangrene. This process is facilitated by the synergistic activity of aerobic bacteria (which cause platelet aggregation and accelerate coagulation through...
Read more Findings and procedure details CT imaging plays a critical role in diagnosing and evaluating the extent of Fournier’s gangrene, offering superior diagnostic capabilities compared to plain radiographs and ultrasound. It is particularly helpful in confirming the diagnosis in unclear cases and in identifying the underlying source of infection. For optimal assessment, the CT scan should cover the abdomen, pelvis, perineum, and scrotum, ensuring a comprehensive evaluation of both the disease’s spread and origin. Limiting the scan to only the pelvis may miss abdominal sources,...
Read more Conclusion Fournier Gangrene is a severe and relatively rare condition with a high mortality rate, where time is critical. While imaging serves as a tool to aid diagnosis, it is instrumental in guiding and prompting treatment. Although other imaging methods, such as X-ray, ultrasound, and MRI, can be used to assess the pathology, CT has proven superior in demonstrating the extent of the infectious process. Beyond its role in surgical planning, CT’s accessibility and speed offer additional benefits, as early diagnosis...
Read more References Escudero-Sepúlveda AF, Cala-Duran JC, Belén-Jurado M, Tomasone SE, Carlino-Currenti VM, Abularach-Borda R, et al. Conceptos para la identificación y abordaje de la gangrena de Fournier. Rev Colomb Cir [Internet]. 2022 Aug 25 [cited 2025 Feb 10]; Available from: https://www.revistacirugia.org/index.php/cirugia/article/view/930 Gaillard F. Radiopaedia. [cited 2025 Feb 10]. Fournier gangrene | Radiology Reference Article | Radiopaedia.org. Available from: https://radiopaedia.org/articles/fournier-gangrene Montrief T, Long B, Koyfman A, Auerbach J. Fournier Gangrene: A Review for Emergency Clinicians. J Emerg Med. 2019 Oct;57(4):488–500. Robinson RR. Gangrena de Fournier. 2006;12. Shyam...
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