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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Main Authors: Richard Gnatzy (Author), Jochen Fuchs (Author), Manuela Siekmeyer (Author), Anne Bettina Beeskow (Author), Jan-Hendrik Gosemann (Author), Martin Lacher (Author)
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Published: Georg Thieme Verlag KG, 2018-01-01T00:00:00Z.
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100 1 0 |a Richard Gnatzy  |e author 
700 1 0 |a Jochen Fuchs  |e author 
700 1 0 |a Manuela Siekmeyer  |e author 
700 1 0 |a Anne Bettina Beeskow  |e author 
700 1 0 |a Jan-Hendrik Gosemann  |e author 
700 1 0 |a Martin Lacher  |e author 
245 0 0 |a Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation 
260 |b Georg Thieme Verlag KG,   |c 2018-01-01T00:00:00Z. 
500 |a 2194-7619 
500 |a 2194-7627 
500 |a 10.1055/s-0038-1667330 
520 |a 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. 
546 |a EN 
690 |a glans ischemia 
690 |a children 
690 |a digital subtraction angiography 
690 |a Pediatrics 
690 |a RJ1-570 
690 |a Surgery 
690 |a RD1-811 
655 7 |a article  |2 local 
786 0 |n European Journal of Pediatric Surgery Reports, Vol 06, Iss 01, Pp e66-e69 (2018) 
787 0 |n http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1667330 
787 0 |n https://doaj.org/toc/2194-7619 
787 0 |n https://doaj.org/toc/2194-7627 
856 4 1 |u https://doaj.org/article/e874acadb54d4d898889a224bef673ea  |z Connect to this object online.