Journal of Gastroenterology and Digestive Diseases

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Journal of Gastroenterology and Digestive Diseases 44 7897 074717

Fulminant Perineal Boils

Lumps and bumps in the perianal region are a frequent referral for surgical care. In this report, we explain a less common cause of extensive perianal and perineal abscess. The case is of a69-year-old diabetic male who performs with an increasingly painful perineum. He is not overweight, but smokes deeply, and suffers from a long history (20 years) of recurrent flares of suppurative perineal cellulitis. Fluctuant lesions stretched from the scrotum anteriorly to the natal cleft posteriorly over a 20cm thickness around the perineum. Computed tomographic (CT) imaging was presented to exclude necrotizing fasciitis , which exhibited localized superficial skin induration without traversing of fascia planes. Multiple low attenuation centers were envisaged consistent with abscesses. In view of his acute perineal sepsis, he was taken to operating theatre. Under anaesthesia, examination showed sinuses connecting the multiple abscesses for which all were drained and laid open.

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