Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Department of Trauma and Emergency (Pediatrics), All India Institute of Medical Sciences, Jodhpur, India.
Am J Trop Med Hyg. 2024 Jul 23;111(4):911-913. doi: 10.4269/ajtmh.24-0223. Print 2024 Oct 2.
Priapism as a complication of scorpionism in children is rare and is categorized as grade II of severity. The pathogenesis is the activation of parasympathetic pathways that stimulate the release of acetylcholine. An 8-year-old boy, a known case of steroid-dependent nephrotic syndrome, presented with a history of persistent penile erection for the previous 12 hours. He had a history of a black scorpion (Heterometrus swammerdami) sting on his right leg 4 days earlier. He was given adequate analgesia, and prazosin was started at 30 µg/kg/dose because of the parasympathetic overactivity. Doppler ultrasonography of the penile shaft showed a bilateral thickened, bulky, and edematous corpus cavernosa and no arterial flow due to venous congestion, suggesting ischemic (low-flow) priapism. Detumescence was not accomplished with saline irrigation and aspiration or with intracorporeal irrigation with phenylephrine. Thus, a distal T-shunt was done. We illustrate an interesting case of scorpion envenomation with delayed ischemic priapism.
儿童蝎子蜇伤后发生阴茎异常勃起较为罕见，被归类为严重程度的 II 级。发病机制是副交感神经通路的激活，刺激乙酰胆碱的释放。一名 8 岁男孩，已知患有类固醇依赖性肾病综合征，他出现持续阴茎勃起 12 小时的病史。他在 4 天前右腿被一只黑蝎子（ Heterometrus swammerdami ）蜇伤。由于副交感神经过度活跃，给予了充分的镇痛，并开始给予 30 µg/kg/剂量的哌唑嗪。阴茎海绵体的多普勒超声显示双侧增厚、肿大和水肿的海绵体，由于静脉充血而没有动脉血流，提示缺血（低流量）性阴茎异常勃起。盐水冲洗和抽吸或用苯肾上腺素进行阴茎内灌洗未能使阴茎疲软。因此，进行了远端 T 分流术。我们展示了一例有趣的蝎子蜇伤后迟发性缺血性阴茎异常勃起的病例。
