case_images: PMC4388072_01
case_images: Severe necrosis of patient's scrotum and perineum.
case_images: cia-10-673Fig1.jpg
case_images: PMC4388072_01_cia-10-673Fig1.jpg
case_images: f1-cia-10-673
case_images: Urology Helios Leipziger Land with decreased general well-being, somnolent, cachexia, arterial hypotension, heart rate of 90 bpm, respiratory frequency of 25 per minute, and urinary incontinence. Upon clinical tegument examination, severe necrosis of the scrotum and perineum were found (Figure 1).
case_images: The perforation of the necrosis with a smell of moisture gangrene.
case_images: cia-10-673Fig2.jpg
case_images: PMC4388072_01_cia-10-673Fig2.jpg
case_images: f2-cia-10-673
case_images: The necrosis had spontaneously perforated, presenting a smell suggesting moist gangrene (Figure 2).
case_images: The dislocated stent from 2008, used to guide the pseudo-cyst's content into the stomach.
case_images: cia-10-673Fig3.jpg
case_images: PMC4388072_01_cia-10-673Fig3.jpg
case_images: f3-cia-10-673
case_images: For stent extraction (Figure 3), a sigmoidoscopy was performed, followed by colostomy, sigmoidal anus praeter, and debridement of the scrotum and peritoneum (Figure 4); during surgery, the distal and sigmoid colon were rinsed with saline and no evidence of perforation was further noticed.
case_images: The wound care: debridement - shown is the 8th day post-surgery.
case_images: cia-10-673Fig4.jpg
case_images: PMC4388072_01_cia-10-673Fig4.jpg
case_images: f4-cia-10-673
case_images: For stent extraction (Figure 3), a sigmoidoscopy was performed, followed by colostomy, sigmoidal anus praeter, and debridement of the scrotum and peritoneum (Figure 4); during surgery, the distal and sigmoid colon were rinsed with saline and no evidence of perforation was further noticed.
case_images: The wound care: debridement - shown is the 11th day post-surgery.
case_images: cia-10-673Fig5.jpg
case_images: PMC4388072_01_cia-10-673Fig5.jpg
case_images: f5-cia-10-673
case_images: Surgical necrosis removal and repeated debridement (Figure 5) under antimicrobiotic protection followed.
case_images: Debridement, suprapubian catheter change and subcutaneous testicle relocation towards the inguinal region - shown is the 30th day post-surgery.
case_images: cia-10-673Fig6.jpg
case_images: PMC4388072_01_cia-10-673Fig6.jpg
case_images: f6-cia-10-673
case_images: Here, debridement, suprapubic catheter change, and subcutaneous testicle relocation towards the inguinal region continued (Figure 6).
case_images: The situation close to patient's release: the wound shows granular tissue formation and is without any visible necrotic areas.
case_images: cia-10-673Fig7.jpg
case_images: PMC4388072_01_cia-10-673Fig7.jpg
case_images: f7-cia-10-673
case_images: From this surgical department, he again left the hospital in good mental health, was spatial and time oriented and cooperative, with stable blood pressure and sustained, spontaneous breathing frequency; the wound did not show any visible necrotic tissue (Figure 7).