Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation

Circumcision is one of the most frequent procedures performed by pediatric surgeons. A dorsal penile nerve block (DPNB) is commonly used for perioperative analgesia. We report the case of a 16-year-old boy with ischemia of the glans who presented on the first postoperative day after circumcision und...

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Chi tiết về thư mục
Những tác giả chính: Richard Gnatzy, Jochen Fuchs, Manuela Siekmeyer, Anne Bettina Beeskow, Jan-Hendrik Gosemann, Martin Lacher
Định dạng: Bài viết
Ngôn ngữ:English
Được phát hành: Georg Thieme Verlag KG 2018-01-01
Loạt:European Journal of Pediatric Surgery Reports
Những chủ đề:
Truy cập trực tuyến:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1667330
Miêu tả
Tóm tắt:Circumcision is one of the most frequent procedures performed by pediatric surgeons. A dorsal penile nerve block (DPNB) is commonly used for perioperative analgesia. We report the case of a 16-year-old boy with ischemia of the glans who presented on the first postoperative day after circumcision under DPNB (0.25% bupivacaine) at an outside hospital. The patient underwent immediate angiography under sedation. An intra-arterial spasmolysis was performed with alprostadil and nitroglycerine and a sufficient perfusion of the glans penis was confirmed. Subsequently, systemic sildenafil, arginine, and heparin were given. Following this 3-day medical treatment, ischemia resolved completely. Our case emphasizes the role of invasive angiography in the diagnostic workup and the therapeutic possibilities of local spasmolysis, systemic vasodilatation, and anticoagulation.
số ISSN:2194-7619
2194-7627