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Author Credentials

Tyler Bayliss, BS David Denning, MD, FACS

Author ORCID Identifier

Tyler Bayliss: 0009-0007-8139-5188

David Denning: 0000-0002-0955-0151

Keywords

CT Scan, Composition Tomography, Fourniers Gangrene, Necrotizing Fasciitis, Necrotizing Soft Tissue Infection, General Surgery

Disciplines

Bacterial Infections and Mycoses | Diagnosis | Investigative Techniques | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Skin and Connective Tissue Diseases | Surgery

Abstract

Clinical reviews of Fournier’s Gangrene state that diagnostic protocol includes interpreting CT, MRI, or Ultrasound imaging along with clinical symptoms and lab findings. We think that the use of imaging techniques as a diagnostic tool is no longer needed as Fournier’s Gangrene is specific enough of a disease that clinicians can diagnose using labs and physical examination alone.

Cases of perirectal necrotizing soft tissue infection recorded at St. Marys Medical Center were reviewed. Results of physical exams and imaging were compared along with measurements of severity upon admittance and length of stay. Due to the COVID-19 pandemic, we investigated if patients were delaying seeking treatment for their condition that those presenting pre-pandemic.

It was found that no additional, clinically significant, information was gained using imaging techniques, particularly CT scans, that wasn’t gathered using a physical exam. The only instances where imaging provided useful were when the patient presented to the clinical setting very early in the disease process. It was also found that a higher number of patients delayed seeking treatment due to the Sars-CoV-2 pandemic. Our sample size was too small to determine whether the number of delayed patients was statistically significant.

We conclude that CT scans are not needed in diagnosing Fournier’s Gangrene unless the disease is in its early stages. This should result in more rapid diagnosis and treatment in the operating room. This is especially important when hospital resources are short and the patient presents in an advanced disease state; relevant to the ongoing Sars-CoV-2 pandemic.

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