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Images: perineal pain and malodorous drainage in a patient with rectal cancer
  1. SreyRam Kuy1,2,
  2. Ramon A L Romero1,2,
  3. Logan Vincent3,
  4. Kyle Rose3
  1. 1Surgical Services, Center for Innovation in Quality, Outcomes and Patient Safety, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana, USA
  2. 2Department of Surgery, Louisiana State University School of Medicine, Shreveport, Louisiana, USA
  3. 3Louisiana State University School of Medicine, Shreveport, Louisiana, USA
  1. Correspondence to Dr SreyRam Kuy, Center for Innovation in Quality, Outcomes and Patient Safety; Surgical Services; Overton Brooks Veterans Affairs Medical Center, 510 E Stoner Ave, Shreveport, LA 71101, USA; sreyram{at}gmail.com

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A 59-year-old diabetic, obese, male smoker was on neoadjuvant chemotherapy for stage IV rectal cancer with liver metastasis. He presented with perineal pain and a foul smell. The patient had a 20×10 cm necrotic wound extending from the posterior scrotum to the anal verge that was tender, malodorous and draining dishwater fluid (figure 1). Urgent debridement of his Fournier's gangrene …

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