An 89-year-old man had a pain in the anus after he ate fish. He consulted a surgeon, and a fish bone was removed from his anus. A week later, he again had increasing pain in the anus. In spite of subsequent antibiotic therapy, his conditions became worse. Computed tomography showed a gas shadow in the perianal and right scrotal area. On admission to the emergency center of our hospital, he developed extensive erythema with severe swelling and necrosis around his scrotum. We performed surgical debridement with antibiotic treatment followed by colostomy six days later. He was discharged on the 90th hospital day with a small residual skin ulcer. Despite removing the fish bone, it was not possible to prevent the development of Fournier's gangrene. In this case, earlier admission with intensive care may have avoided the need for colostomy when a fish bone was found in the anus.
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