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...
| मुख्य लेखकों: | , , , , , |
|---|---|
| स्वरूप: | लेख |
| भाषा: | English |
| प्रकाशित: |
Georg Thieme Verlag KG
2018-01-01
|
| श्रृंखला: | European Journal of Pediatric Surgery Reports |
| विषय: | |
| ऑनलाइन पहुंच: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1667330 |
| _version_ | 1831517854128668672 |
|---|---|
| author | Richard Gnatzy Jochen Fuchs Manuela Siekmeyer Anne Bettina Beeskow Jan-Hendrik Gosemann Martin Lacher |
| author_facet | Richard Gnatzy Jochen Fuchs Manuela Siekmeyer Anne Bettina Beeskow Jan-Hendrik Gosemann Martin Lacher |
| author_sort | Richard Gnatzy |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T23:57:32Z |
| format | Article |
| id | doaj.art-e874acadb54d4d898889a224bef673ea |
| institution | Directory Open Access Journal |
| issn | 2194-7619 2194-7627 |
| language | English |
| last_indexed | 2024-12-11T23:57:32Z |
| publishDate | 2018-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | European Journal of Pediatric Surgery Reports |
| spelling | doaj.art-e874acadb54d4d898889a224bef673ea2022-12-22T00:45:19ZengGeorg Thieme Verlag KGEuropean Journal of Pediatric Surgery Reports2194-76192194-76272018-01-010601e66e6910.1055/s-0038-1667330Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and AnticoagulationRichard Gnatzy0Jochen Fuchs1Manuela Siekmeyer2Anne Bettina Beeskow3Jan-Hendrik Gosemann4Martin Lacher5Department of Pediatric Surgery, University of Leipzig, Leipzig, GermanyDepartment of Diagnostic and Interventional Radiology, 310 Klinik GmbH, Nuremberg, GermanyHospital for Children and Adolescents, University of Leipzig, Leipzig, GermanyDepartment of Radiology, University of Leipzig, Leipzig, GermanyDepartment of Pediatric Surgery, University of Leipzig, Leipzig, GermanyDepartment of Pediatric Surgery, University of Leipzig, Leipzig, GermanyCircumcision 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1667330glans ischemiachildrendigital subtraction angiography |
| spellingShingle | Richard Gnatzy Jochen Fuchs Manuela Siekmeyer Anne Bettina Beeskow Jan-Hendrik Gosemann Martin Lacher Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation European Journal of Pediatric Surgery Reports glans ischemia children digital subtraction angiography |
| title | Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation |
| title_full | Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation |
| title_fullStr | Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation |
| title_full_unstemmed | Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation |
| title_short | Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation |
| title_sort | glans ischemia after circumcision in a 16 year old boy full recovery after angiography with local spasmolysis systemic vasodilatation and anticoagulation |
| topic | glans ischemia children digital subtraction angiography |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1667330 |
| work_keys_str_mv | AT richardgnatzy glansischemiaaftercircumcisionina16yearoldboyfullrecoveryafterangiographywithlocalspasmolysissystemicvasodilatationandanticoagulation AT jochenfuchs glansischemiaaftercircumcisionina16yearoldboyfullrecoveryafterangiographywithlocalspasmolysissystemicvasodilatationandanticoagulation AT manuelasiekmeyer glansischemiaaftercircumcisionina16yearoldboyfullrecoveryafterangiographywithlocalspasmolysissystemicvasodilatationandanticoagulation AT annebettinabeeskow glansischemiaaftercircumcisionina16yearoldboyfullrecoveryafterangiographywithlocalspasmolysissystemicvasodilatationandanticoagulation AT janhendrikgosemann glansischemiaaftercircumcisionina16yearoldboyfullrecoveryafterangiographywithlocalspasmolysissystemicvasodilatationandanticoagulation AT martinlacher glansischemiaaftercircumcisionina16yearoldboyfullrecoveryafterangiographywithlocalspasmolysissystemicvasodilatationandanticoagulation |