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Acute glans ischemia after circumcision successfully treated with low-molecular-weight heparin and topical dihydrotestosterone: A case report.

低分子肝素和局部双氢睾酮成功治疗包皮环切术后急性龟头缺血: 病例报告。

  • 影响因子:1.95
  • DOI:10.1097/MD.0000000000021340
  • 作者列表:"Zvizdic Z","Anic D","Popovic N","Vranic S
  • 发表时间:2020-07-17
Abstract

RATIONALE:Circumcision like any other surgical procedure is not devoid of complications. Serious complications are rare and include iatrogenic hypospadias, glans ischemia/necrosis, and glans amputation, all of which require an emergent treatment. PATIENT CONCERNS:We report here a case of 6 months-old-boy with a superficial glans ischemia following circumcision. DIAGNOSIS:Physical examination revealed a severely cyanotic glans with the moderate edema of the dorsal penile skin. Plasma levels of D-dimer were 8.57 mg/L. Urine passage was unremarkable while color Doppler ultrasonography revealed a normal blood flow. INTERVENTIONS:The patient was successfully treated with subcutaneous injection of enoxaparin (low-molecular-weight heparin) and topical 2.5% dihydrotestosterone. OUTCOMES:The appearance of the glans penis on the 5th day was close to normal while the control levels of D-dimer dropped to the reference range. The patient was discharged from the hospital on the 6th day. At 6-month follow-up, the appearance of the glans penis was normal. LESSONS:Acute glans penis ischemia following circumcision is a rare complication. Its successful treatment with enoxaparin and topical dihydrotestosterone has not been previously reported in the literature.

摘要

理由: 包皮环切术与其他任何外科手术一样,并非没有并发症。严重的并发症是罕见的,包括医源性尿道下裂、龟头缺血/坏死和龟头截肢,所有这些都需要紧急治疗。 患者关注的问题: 我们在这里报告一例6个月大的男孩在包皮环切术后浅表龟头缺血。 诊断: 体格检查发现严重发绀的龟头,阴茎背皮肤中度水肿。血浆D-二聚体水平为8.57 mg/L。尿流未见异常,彩色多普勒超声检查血流正常。 干预措施: 患者皮下注射依诺肝素 (低分子肝素) 和外用2.5% 双氢睾酮治疗成功。 结果: 第5天阴茎龟头的外观接近正常,而D-二聚体的对照水平降至参考范围。患者于第6天出院。6个月随访时,阴茎龟头外观正常。 教训: 包皮环切术后急性阴茎龟头缺血是一种罕见的并发症。用依诺肝素和局部用双氢睾酮成功治疗,此前文献中未见报道。

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泌尿外科手术方向

泌尿系统出现一些病变,需要通过手术来治疗,这些手术就称为泌尿外科手术。

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