Fournier's Gangrene Associated With Untreated Crohn's Disease in a Male Patient: A Case Report and Review of the Literature

Crohn's disease is a chronic idiopathic inflammatory bowel disease that can affect any part of the gastrointestinal tract. Perianal symptoms are seen in one-third of Crohn's disease cases, with perianal abscesses leading to Fournier's gangrene being extremely rare. Herein, we discuss an interesting case of a male patient with Fournier's gangrene as a result of untreated Crohn's disease. A 51-year-old male presented to the emergency department with a perianal abscess and cellulitis of the perineum. Examination under general anesthesia (EUA) of the rectum and incision and drainage (I&D) of the abscess were performed urgently, leading to the diagnosis of Fournier's gangrene. Subsequent investigations revealed that the causative factor was a previously diagnosed but untreated Crohn's disease. The comprehensive treatment plan included fecal diversion, regular surgical debridement, negative pressure wound therapy, antibiotics administration, and perineal reconstruction. After a 37-day hospital stay, the patient was discharged in good clinical condition and referred to a specialized gastroenterologist for further treatment. A year later, he underwent an ileocecal resection with ileocolic anastomosis. In rare circumstances, Crohn's disease may manifest solely through perianal symptoms and, even more rarely, as Fournier's gangrene. It is crucial for clinicians to be aware of this manifestation for early diagnosis and prompt treatment. Maintaining a high level of suspicion, achieving early diagnosis, implementing prompt resuscitation, and adopting a multidisciplinary approach within specialized medical centers are crucial factors for effective management in these cases.