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病例报告:因终末期慢性肾病导致包茎伴钙过敏引发的阴茎坏死。

Case Report: Penile necrosis associated to paraphimosis with calciphylaxis due to terminal chronic kidney disease.

作者信息

Grandez-Urbina J Antonio, Corrales-Acosta Elizabeth, Tejeda-Mariaca J Eduardo, Pichardo-Rodriguez Rafael, Garcia-Perdomo Herney

机构信息

Universidad Continental, Calle Junín 355, Miraflores, Lima, 15046, Peru.

Urology Deparment, Hospital Alberto Leopoldo Barton Thompson, Avenida Argentina 29, Callao, 07001, Peru.

出版信息

F1000Res. 2019 Jul 19;8:1133. doi: 10.12688/f1000research.18834.1. eCollection 2019.

Abstract

: Penile necrosis is a rare condition that may present in patients with diabetes mellitus or chronic kidney disease (CKD). The recommended treatment is controversial. We report a case of penile necrosis in a diabetic patient caused by episode of paraphimosis associated with uremic arteriopathy treated with partial amputation. : A 53-year-old male with a background of arterial hypertension, diabetes mellitus and CKD in hemodialysis. The patient presented with paraphimosis and glans necrosis. An emergency circumcision was carried out. A doppler ultrasound found fluid collection in the left corpus cavernosum, parietal vascular calcifications and vascular insufficiency in the corpus cavernosum that suggested necrosis. A partial amputation of the penis was carried out. After three years of follow-up, the outcome has remained favorable. : Penile necrosis is a rare but serious complication of terminal CKD. In these patients, systemic calciphylaxis is usually observed. The main take-away lesson is that a multidisciplinary approach is necessary.

摘要

阴茎坏死是一种罕见的病症,可能出现在糖尿病或慢性肾脏病(CKD)患者中。推荐的治疗方法存在争议。我们报告一例糖尿病患者阴茎坏死病例,该病例由包茎嵌顿发作与尿毒症性动脉病相关,经部分截肢治疗。一名53岁男性,有动脉高血压、糖尿病和接受血液透析的CKD病史。患者出现包茎嵌顿和龟头坏死。进行了急诊包皮环切术。多普勒超声检查发现左侧海绵体有积液、阴茎海绵体血管钙化和血管功能不全,提示坏死。对阴茎进行了部分截肢。经过三年随访,结果良好。阴茎坏死是晚期CKD罕见但严重的并发症。在这些患者中,通常会观察到系统性钙化防御。主要的经验教训是需要多学科方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e61b/6685455/8d49b8f0c6fc/f1000research-8-20638-g0000.jpg

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