PERINEAL GANGRENE: AN EXPERIENCE OF DIGESTIVE AND PROCTOLOGIC SURGICAL UNIT, UNIVERSITY HOSPITAL OF TREICHVILLE

Background: Perineal gangrene is a serious and relatively frequent disease in Africa and particularly in Côte d’Ivoire. The aim of this study was to show etiology, presentation, and management in developing country. Material Methods: This retrospective study was carried over a period of nine years from January 2004 to December 2012 at University Hospital of Treichville. The sex, age, etiology, presentation, risk factors and management were studied. Chi square test was applied with a sensitivi of 5%. Results: Thirty-one patients were studied. The patients’ mean age was 45 years with a male prevalence (27 men for 4 women). Nicotinic and alcoholic intoxication was noted in 14 cases, diabetes (n=4), HIV disease (n=2) and cardiomyopathy (n=1). An etiology was identified in 20 patients, dominated by the anal fistula (n=10). The average time of consultation was 12 days. All patients were at the stage of gangrene which was extended to the near areas in 5 cases. The reanimation, the excision of necrotic tissues and the antibiotherapy constituted the essence of treatment. Daily dressings after sit bath in Dakin were associated. No colostomy was carried out. The mortality was 22.6% (n=7). The presence of shock and high serum creatinine were bad prognostic signs. Conclusion: Perineal gangrene is a serious disease that affects adult males more frequently. It may arise from traumatic lesions or infections of perineal area. Delayed presentation is a common feature of advanced lesions. An early consultation in all perineal nuisances whatever their origin, might prevent and improve the prognosis