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A Case Report of Fournier s Gangrene after Sclerosing Therapy for Internal Hemorrhoids with Aluminum Potassium Sulfate and Tannic Acid (ALTA) Injection Aluminum potassium sulfate and tannic acid (ALTA) injection has recently been employed as a new treatment for internal hemorrhoids. We report the case of a patient who developed Fournier s syndrome after ALTA injection, along with a review of the literature. A 73-year-old male with internal hemorrhoids was treated with sclerosing therapy employing ALTA injection (Zione injection). Four days after infection, he developed a fever and anal pain. Antibiotics were administered, but remission was not achieved. He was diagnosed with Fournier s syndrome. Debridement was performed under local anesthesia the following day, with the wound kept open to allow for drainage. Marked intestinal edema, inflammatory stenosis, and mucosal necrosis were observed in the rectal mucosa where ALTA was injected. Subsequently, necrosed mucosa and a fistula were observed in the rectum. The rectal fistula still remained 7 months after onset, but the edema was gradually resolved. This is the first report of Fournier s syndrome associated with ALTA injection.