Endocrine Abstracts

Introduction: Fournier’s gangrene is a rapidly progressive necrotizing fasciitis affecting the perineum and external genital organs, requiring prompt, comprehensive, and multidisciplinary therapeutic intervention due to its severity. Diabetic patients are particularly at risk of developing Fournier’s gangrene due to their vulnerability to infections and healing complications.

Objective: To present the clinical, therapeutic, and evolutionary aspects in diabetic patients.

Patients and Methods: A retrospective descriptive study, including 26 diabetic patients with Fournier’s gangrene hospitalized at Ibn Rochd University Hospital in Casablanca. Twenty patients had known diabetes, while in 6 cases, gangrene was indicative of diabetes. Statistical analysis was conducted using Excel.

Results: The average age of our patients was 56 years, with a male predominance (24 men and 2 women). Twenty-five patients had type 2 diabetes (96%), and one patient had type 1 diabetes. All patients were uncontrolled at the onset of gangrene (average HbA1c of 9.8%). Uro-genital and ano-rectal causes were noted. Medical management involved parenteral tri-antibiotic therapy, intensive insulin therapy (basal-bolus regimen), and hypercaloric feeding (parenteral nutrition in 4 cases). Surgical treatment (necrotomy) was performed in all cases. Colostomy was carried out in 6 cases. Skin grafting was necessary in 1 case. Two deaths (7.69%) were recorded in cases of septicemia.

Conclusion: Fournier’s gangrene remains a severe condition, especially in diabetic patients, and prognosis can only be improved through early diagnosis and appropriate medical and surgical management.