索马里农村地区传统男性包皮环切术后的严重伤口感染及并发症:资源有限环境下的一例医疗事故报告
Severe Wound Infection and Complications Following Traditional Male Circumcision in Rural Somalia: A Case Report of Malpractice in a Resource-Limited Setting.
作者信息
Elmi Abdullahi Hassan, Omar Abdullahi Abdirahman, Dirie Najib Isse, Abdi Ahmed Omar, Garba Bashiru
机构信息
Department of Nursing and Midwifery, Dr. Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.
Dr. Sumait Hospitals, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.
出版信息
Int Med Case Rep J. 2025 May 16;18:553-558. doi: 10.2147/IMCRJ.S522255. eCollection 2025.
INTRODUCTION
Traditional male circumcision (TMC) is a common cultural and religious practice in Somalia. However, procedures performed by untrained practitioners under non sterile conditions can result in severe complications. This case report describes the delayed presentation and successful management of a 6-year-old boy who experienced wound infection and complications following a traditional circumcision.
CASE PRESENTATION
A 6-year-old boy from Shaan Town, Middle Shabelle region, Somalia, presented with urinary retention, lower abdominal pain, and penile discharge 15 days after traditional circumcision performed using non-sterile equipment. Initially, he experienced painful urinary dribbling progressing to complete urinary retention, accompanied by local infection characterized by swelling, redness, and foul-smelling discharge. Despite oral antibiotics administered at home, his condition deteriorated, prompting hospital admission near Mogadishu, where intravenous antibiotics and catheterization were initiated. Due to worsening symptoms, the patient was referred to our tertiary facility, where surgical debridement and primary closure of necrotic circumcision tissue were successfully performed. Postoperative recovery was uneventful, with complete normalization of urinary function and resolution of infection. Follow-up examinations at two weeks and one month confirmed satisfactory healing without residual complications.
CONCLUSION
This case underscores the significant risks of traditional circumcision performed by untrained practitioners, emphasizing the need for public health interventions. This report highlights the importance of integrating safe medical practices into cultural frameworks to improve outcomes in resource-limited settings.
引言
传统男性包皮环切术(TMC)在索马里是一种常见的文化和宗教习俗。然而,未经培训的从业者在非无菌条件下进行手术可能会导致严重并发症。本病例报告描述了一名6岁男孩在传统包皮环切术后出现伤口感染及并发症的延迟就诊情况及成功治疗过程。
病例介绍
一名来自索马里中谢贝利地区沙安镇的6岁男孩,在使用非无菌设备进行传统包皮环切术后15天,出现尿潴留、下腹部疼痛和阴茎分泌物。最初,他经历了疼痛性尿滴沥,逐渐发展为完全尿潴留,并伴有局部感染,表现为肿胀、发红和有异味的分泌物。尽管在家中服用了口服抗生素,他的病情仍恶化,促使他在摩加迪沙附近住院,在那里开始了静脉注射抗生素和导尿治疗。由于症状恶化,患者被转诊至我们这所三级医疗机构,在那里成功进行了手术清创和坏死包皮环切组织的一期缝合。术后恢复顺利,排尿功能完全恢复正常,感染得到解决。两周和一个月后的随访检查证实愈合良好,无残留并发症。
结论
本病例强调了未经培训的从业者进行传统包皮环切术的重大风险,强调了公共卫生干预的必要性。本报告强调了将安全的医疗实践融入文化框架以改善资源有限环境下治疗效果的重要性。
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