Wu Xilin, Batra Ramesh, Al-Akraa Mahmoud, Seneviratne Lasantha Niroshan
Department of Urology, Royal Free Hospital, London, UK.
BMJ Case Rep. 2012 Sep 25;2012:bcr2012006466. doi: 10.1136/bcr-2012-006466.
Penoscrotal entrapment is a rare urological emergency that requires urgent treatment to avoid penile ischaemia and subsequent erectile dysfunction. Non-metallic and thin metallic objects are easily removed via cutting, while thick metallic constricting devices require specialist saws or motorised cutters, all of which may be difficult to locate in the emergency setting. We report a case of a 45-year-old patient who presented with a 48-h history of gross penoscrotal oedema secondary to entrapment by a thick metal ring (internal diameter 55 mm, external diameter 74 mm and thickness 19 mm). The positioning, thickness of the ring, delayed presentation and extensive oedema meant its removal was especially challenging. We improvised a simple, three-step technique (aspiration, strapping and sling) which enabled the metal ring to be removed without the need for specialist equipment. We would encourage others to employ this safe technique in an emergency setting.
阴茎阴囊绞窄是一种罕见的泌尿外科急症，需要紧急治疗以避免阴茎缺血及随后的勃起功能障碍。非金属和薄金属物体可通过切割轻松取出，而厚金属束缚装置则需要专业锯或电动切割器，在急诊环境中这些工具可能难以找到。我们报告一例45岁患者，因被一个厚金属环（内径55毫米、外径74毫米、厚度19毫米）绞窄导致阴茎阴囊严重水肿48小时前来就诊。金属环的位置、厚度、就诊延迟及广泛水肿意味着其取出极具挑战性。我们临时想出一种简单的三步技术（抽吸、绑扎和悬吊），无需专业设备就能取出金属环。我们鼓励其他人在急诊环境中采用这种安全技术。
