PERFORATED COLONIC-CARCINOMA PRESENTING AS EPIDIDIMOORCHITIS AND FOURNIERS GANGRENE

Epididymo-orchitis is a relatively common diagnosis in elderly men, of ten related to prostatic outflow obstruction, A 70-year-old man presen ted with a 4-day history of swelling and pain in the scrotum, fevers, dysuria and frequency, He had severe symptoms of prostatic hypertrophy . Physical examination and urine microscopy confirmed the diagnosis of left epididymo-orchitis and antimicrobial therapy was commenced. Subs equently, however, he developed severe necrotizing fasciitis (Fournier 's gangrene) of the scrotum requiring surgical debridement, and at lap arotomy, a performated carcinoma of the sigmoid colon was found at the level of the left deep inguinal ring, Despite further radical surgery the gangrene extended, his condition deteriorated and he died, There has been no other similar case reported in the literature, and thus, a lthough rare, intra-peritoneal causes of infection should be considere d in patients with Fournier's gangrene.