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楼梯坠落致阴茎污染伤口手术治疗效果良好:病例报告

Good outcome of surgical treatment for contaminated penile wound due to a fall from stairs: a case report.

作者信息

Patel Neil, Kaka Nirja, Sharma Pradeep, Mahajan Neha, Ansari Rehnuma, Sethi Yashendra

机构信息

Department of Medicine, GMERS Medical College, Himmatnagar, India.

Department of Surgery, Government Doon Medical College, Dehradun, India.

出版信息

AME Case Rep. 2023 May 8;7:29. doi: 10.21037/acr-22-60. eCollection 2023.

Abstract

BACKGROUND

Penile trauma due to the associated stigma poses a diagnostic challenge. The causes of isolated penile injuries include zipper injuries (mainly in children), falls, burns, during fellatio, self-mutilation (Klingsor syndrome), and rarely purposeful forceful bending of the erect penis (Taqaandan). Delayed management of penile trauma might increase the risk of infection, rarely leading to sepsis acutely or structural and functional disabilities in the long run. We believe our report is the first to contribute data on a patient with a delayed presentation of contaminated penile wound who recovered well with prompt management.

CASE DESCRIPTION

A traumatic laceration of the penis due to a fall from stairs is extremely unexpected. Here we present the case of a 14-year-old boy who slipped from the stairs and got an isolated American Association for the Surgery of Trauma (AAST) Grade-1 ventrolateral penile skin laceration. He took home remedies for 10 days before reporting with a contaminated wound. The patient was first managed conservatively with antibiotics [Amoxyclav 625 mg thrice daily (TDS) and Metronidazole 400 mg TDS], wound care, and then treated surgically, helping wound repair. He recovered well after the treatment and retained normal urinary and sexual function.

CONCLUSIONS

Penile trauma is severely under-reported due to the stigma associated with it. Early diagnosis and prompt management are imperative to limit complications. A detailed history helps to evaluate the exact cause and check out possibilities of sexual assault. Appropriate management in tandem with patient education and an attempt to de-stigmatize the interaction helps favorable long-term outcomes.

摘要

背景

由于相关的污名化,阴茎创伤带来了诊断挑战。孤立性阴茎损伤的原因包括拉链损伤(主要见于儿童)、跌倒、烧伤、口交时、自残(克林索综合征),以及极少出现的勃起阴茎的故意强力弯曲(塔卡丹)。阴茎创伤的延迟处理可能会增加感染风险,极少会急性导致败血症,或长期导致结构和功能残疾。我们认为我们的报告首次提供了关于一名阴茎伤口污染延迟就诊患者的数据,该患者经及时处理后恢复良好。

病例描述

因从楼梯上跌落导致阴茎撕裂伤极其意外。在此,我们报告一例14岁男孩的病例,他从楼梯上滑倒,造成孤立性美国创伤外科学会(AAST)1级阴茎腹外侧皮肤撕裂伤。他自行采取家庭疗法10天后,因伤口污染前来就诊。患者最初接受保守治疗,使用抗生素[阿莫西林克拉维酸625毫克,每日三次(TDS)和甲硝唑400毫克,TDS]、伤口护理,随后接受手术治疗,促进伤口修复。治疗后他恢复良好,保留了正常的排尿和性功能。

结论

由于与之相关的污名化,阴茎创伤的报告严重不足。早期诊断和及时处理对于限制并发症至关重要。详细的病史有助于评估确切病因,并排查性侵犯的可能性。与患者教育相结合的适当处理以及消除这种互动污名化的努力有助于取得良好的长期结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c3/10364008/b53b52f4927d/acr-07-22-60-f1.jpg

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