Codrich D, Boscarelli A, Cerrina A, Scarpa MG, Iaquinto M, Olenik D, Guida E, Schleef J. Glans ischemia after circumcision in children: Two case reports. World J Clin Pediatr 2021; 10(4): 79-83 [PMID: 34316441 DOI: 10.5409/wjcp.v10.i4.79]
Corresponding Author of This Article
Alessandro Boscarelli, MD, Surgeon, Department of Pediatric Surgery and Urology, Institute for maternal and child health-IRCCS Burlo Garofolo, via dell'Istria, 65/1, Trieste 34137, Italy. tboscar@hotmail.it
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Daniela Codrich, Alessandro Boscarelli, Alessia Cerrina, Maria-Grazia Scarpa, Marianna Iaquinto, Damiana Olenik, Edoardo Guida, Jurgen Schleef, Department of Pediatric Surgery and Urology, Institute for maternal and child health-IRCCS Burlo Garofolo, Trieste 34137, Italy
Author contributions: Codrich D, Boscarelli A and Cerrina A collected the data, conceptualized the report and drafted the initial manuscript; Scarpa MG, Iaquinto M and Olenik D contributed to the collection of iconographic material and revised the manuscript; Guida E and Schleef J contributed to critically review the manuscript for important intellectual content and language editing.
Informed consent statement: Consent to publish the case report not obtained. The report does not contain any personal information that could lead to identification of the patient.
Conflict-of-interest statement: The authors have no conflicts of interest related to this article to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alessandro Boscarelli, MD, Surgeon, Department of Pediatric Surgery and Urology, Institute for maternal and child health-IRCCS Burlo Garofolo, via dell'Istria, 65/1, Trieste 34137, Italy. tboscar@hotmail.it
Received: December 30, 2020 Peer-review started: December 30, 2020 First decision: May 6, 2021 Revised: May 11, 2021 Accepted: June 4, 2021 Article in press: June 4, 2021 Published online: July 9, 2021 Processing time: 188 Days and 15.6 Hours
Abstract
BACKGROUND
Circumcision refers to the removal of the skin covering the tip of the penis and is one of the most common surgical procedures performed in childhood. Even though circumcision is a well-standardized operation, several minor and major complications may be experienced by paediatric surgeons. Glans ischemia (GI) has been widely reported in the paediatric literature as a complication following circumcision. Nonetheless, etiopathogenesis of GI is not well defined and management guidelines are lacking.
CASE SUMMARY
We describe our experience with this rare and scary complication using subcutaneous enoxaparin alone or in association with a topical vasodilator.
CONCLUSION
Hypothetical causes and different management strategies are discussed.
Core Tip: Glans ischemia (GI) after circumcision is a rare complication, which has been widely described by paediatric surgeons in the modern literature. To date, etiopathogenesis of GI is not well defined and management guidelines are lacking. In order to achieve a prompt diagnosis and to start appropriate treatment, an accurate postoperative medical assessment and parental education are crucial before hospital discharge for children undergoing circumcision.
