Which anatomic relationships of the vascular system are relevant in the pathogenesis of Fournier gangrene?

Updated: Jun 03, 2021
  • Author: Vernon M Pais, Jr, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Branches from the inferior epigastric and deep circumflex iliac arteries supply the lower aspect of the anterior abdominal wall. Branches of the external and internal pudendal arteries supply the scrotal wall. With the exception of the internal pudendal artery, each of these vessels travels within Camper fascia and can therefore become thrombosed in the progression of Fournier gangrene.

Thrombosis jeopardizes the viability of the skin of the anterior scrotum and perineum. Since the internal pudendal artery is not contained within Camper fascia, it is less susceptible to thrombosis; therefore, its vascular territory—the posterior aspect of the scrotal wall—remains viable and can be used in the reconstruction following resolution of the infection.


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