外陰部の壊死性筋膜炎と凍傷との鑑別が困難であった1例

Wakako Yorozuya, Ko Kobayashi, Seisuke Nofuji, Masahiro Matsuki, Kohei Hashimoto, Shinji Kato, Naoya Masumori

We report a case diagnosed as both necrotizing fasciitis and frostbite of the male external genetalia. The patient was a 58-year-old man with diabetes mellitus. He was referred to our hospital with swelling of his penis and icing there for 3 weeks. We diagnosed his condition as necrotizing fasciitis of the external genitalia and decided to perform an emergency operation. Although we consulted plastic surgeons about debridement of a large area, they considered that there was no necessity for it because the scrotum, perineum and abdominal wall were frostbitten. The final clinical diagnosis was necrotizing fasciitis of the penile region and frostbite around the perineal region. We performed partial penectomy without debridement. Through collaboration with another medical department it was thus possible to avoid unnecessary invasive treatment.