PMC3034918_01
Computed tomography of the pelvis dipecting extensive emphysema around the testicles and perineal subcutaneous tissue.
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C-reactive protein (CRP) was 25 mg/dL, and blood glucose was 300 mg/dL. Computed tomography of the lower abdomen and pelvis revealed extensive emphysema around the testicles, perineal subcutaneous tissue, and around the left internal iliac vessels (Figure 1).
(a) Preoperative image showing considerable edema and scrotal necrosis. (b) Intraoperative image of the immediate surgical debridement demonstrating the extensive necrosis of the scrotum and perianal region.
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He was treated with immediate extensive surgical debridement under general anesthesia (Figures 2(a) and 2(b)).
Wide-open drainage of the necrotic skin in the scrotum and perineal area.
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The necrotic skin in the scrotum and the perianal region was evacuated into a wide-open drainage area, without any damage to the testicles spermatic cords, or external sphincter (Figure 3).
The left testicle is transpositioned into a subcutaneous pocket in the inner side of the left thigh.
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Due to the fact that his left testicle was severely exposed, it was transpositioned into a subcutaneous pocket in the inner side of the left thigh on the 7th postoperative day (Figure 4).
Image of the surgical wound four weeks after the initial operation showing that the gas gangrene has completely resolved, the wide wound is reduced, and good granulation is present.
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The infection gradually subsided, the gas gangrene resolved completely, and good granulation was present four weeks after surgery (Figure 5).