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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Autores principales: Gnatzy, Richard, Fuchs, Jochen, Siekmeyer, Manuela, Beeskow, Anne Bettina, Gosemann, Jan-Hendrik, Lacher, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162192/
https://www.ncbi.nlm.nih.gov/pubmed/30276065
http://dx.doi.org/10.1055/s-0038-1667330
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author Gnatzy, Richard
Fuchs, Jochen
Siekmeyer, Manuela
Beeskow, Anne Bettina
Gosemann, Jan-Hendrik
Lacher, Martin
author_facet Gnatzy, Richard
Fuchs, Jochen
Siekmeyer, Manuela
Beeskow, Anne Bettina
Gosemann, Jan-Hendrik
Lacher, Martin
author_sort Gnatzy, Richard
collection PubMed
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.
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spelling pubmed-61621922018-10-01 Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation Gnatzy, Richard Fuchs, Jochen Siekmeyer, Manuela Beeskow, Anne Bettina Gosemann, Jan-Hendrik Lacher, Martin European J Pediatr Surg Rep 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. Georg Thieme Verlag KG 2018-01 2018-09-28 /pmc/articles/PMC6162192/ /pubmed/30276065 http://dx.doi.org/10.1055/s-0038-1667330 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Gnatzy, Richard
Fuchs, Jochen
Siekmeyer, Manuela
Beeskow, Anne Bettina
Gosemann, Jan-Hendrik
Lacher, Martin
Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation
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
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162192/
https://www.ncbi.nlm.nih.gov/pubmed/30276065
http://dx.doi.org/10.1055/s-0038-1667330
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