Sünnetin Beklenmeyen Bir Komplikasyonu: Nekrotizan Fasiit

Öz

Sünnet en eski cerrahi prosedürlerden biridir. Sünnet sıklıkla dinsel, profılaktik ve acil medikal endikasyonlar nedeniyle uygulanır. Bu cerrahi prosedür iyi bir bakım gerektirir ve hastane koşullarında uzmanlaşmış cerrahlar tarafından yapılmalıdır. Buna rağmen sünnet kısa ve kolay bir operasyon gibi göründüğünden birçok komplikasyonla sonuçlanır. Biz bu çalışmada penis gövde cildinde tamama yakın nekroz ve nekrotizan fasiiti olan bir vakayı raporladık.

Anahtar Kelimeler

• Sünnet
• nekroz
• fasiit

An Extreme Complication of Circumcision: Necrotizing Fasciitis

Öz

Circumcision is one of the oldest surgical procedures. It is performed frequently for religious, prophylactic and immediate medical indications. It is a surgical procedure that requires maximum care and it must be performed by licensed surgeons in hospital conditions. Although it seems like a short and easy operation to perform, it can result with serious complications. In this study, we report a case with a near total penile shaft necrosis and necrotizing fasciitis and we want to take attention to this serious complication of circumcision.

Anahtar Kelimeler

• Circumcision
• necrosis
• fasciitis

Kaynakça

1. 1. Erk Y, Kocabalkan 0. A case report of penis reconstruction for partial penis necrosis following circumcision. Türkiye Klinikleri J Pediatrics 1995; 37: 79-82.
2. 2. Cathcart P, Nuttall M, Meulen J, Emberton M, Kenny SE. Trends in paediatric circumcision and its complications in England between 1997 and 2003. Br J Surg 2006; 93: 885-90.
3. 3. Taddio A, Pollock N, Gilbert-Mac Leod C, Ohlsson K, Koren G. Combined analjesia and local anesthesia to minimize pain during circumcision. Arch Pediatr Adolesc Med 2000;154:620-3.
4. 4. Yegane RA, Kheirollahi AR, Salehi NA, Bashashati M, Khoshdel JA, Ahmadi M. Late complications of circumcision in Iran. Pediatr Surg Int 2006; 22:442-5.
5. 5. Atikeler MK, Geçit I, Yüzgeç V, Yalçın 0. Complications of circumcision performed within and outside the hospital. Int Urology and nefrology 2005; 37: 97-9.
6. 6. Lau JT. Penile block for pain relief after circumcision in children. A randomized, prospective trial. Am J Surg 1984; 147: 797-9.
7. 7. Williams N, Kapila L. Complications of circumcision. Br J Surg 1993; 80:1231-6.
8. 8. Stang HJ, Snellman LW. Circumcision practice patterns in the United States. Pediatrics 1998;101:E5.

9. 9. Özdemir E. Significant increased complication risks with mass circumcisions. Br J Urol 1997; 80:136-9.
10. 10. Atikeler M, Onur R, Geçit I. Increased morbidity after circumcision from a hidden complication. Br J Urol 2001; 88: 938-40.
11. 11. Özkan S, Gürpınar TA. Serious circumcision complication: Penile shaft amputation and a new reattachment technigue with a successful outcome. J Urol 1997;158:1946-7.
12. 12. Rickwood AM. Medical indications for circumcision. BJU Int 1999; 83(suppl. 1): 45-51.
13. 13. Weksler N, Atıas I, Klein M, Rosenztveıg V, Ovadıa L, Gurman GM. Is penile block beter than caudal epidural block for postcircumcision analjesia?. J Anesth 2005;19:36-9.
14. 14. Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision. Pediatrics 1999; 103: 686-93.
15. 15. Spilbury K, Semmens JB, Wisniewski Z, Holman CD. Routine circumcision practice in Western Australia 1981-1999. ANZ J Surg 2003; 73: 610-4.
16. 16. Demirseren ME, Gokrem S. Circumcision in unqualified hands: a significant risk of com- plication. Plast Reconstr Surg 2004; 113: 1090-2.
17. 17. Ahmed A, Mbibi NH, Dawam D, Kalayi GD. Complications of traditional male circumcision. Ann Trop Paediatr 1999;19:113-7.
18. 18. Sahin F, Beyazova U, Akturk A. Attitudes and practices regarding circumcision in Turkey. Child Care Health Dev 2003; 29:275-80.
19. 19. Rizvi SA, Naqi SA, Hussain M. Religious circumcision: a Muslim view. BJU Int 1999; 83: 13-16.
20. 20. Schmitz RF, Schulpen TW, Redjopawiro MS, Liem MS, Madem GC, Werken C. Religious circumcision under local anaesthesia with a new disposable clamp. BJU International 2001; 88: 581-5.
21. 21. Emsen IM. Catastrophic complication ofthe circumcision that carried out with local anesthesia contained adrenaline. J Trauma 2006:60:1150.
22. 22. Soliman MG, Tremblay NA. Nerve block of the penis for postoperative pain relief in children. Anesth Analg 1978; 57: 495-8.
23. 23. Kirya C, Wethmann MW Jr. Neonatal circumcision and penile dorsal nerve block-Apainless procedure. J Pediatr 1978; 92: 998-1000.
24. 24. Stang HJ, Gunnar MR, Snellman L, Condon LM, Kestenbaum R. Local anesthesia for neonatal circumcision. Effects on distress and cortisol response. JAMA 1988; 259:1507-11.
25. 25. Weiss GN. Neonatal circumcision. South Med J 1985; 78:1198-200.
26. 26. Baran NK, Horton CE. Growth of skin grafts, flaps and scars in young minipigs. Plast Reconstr 1972;50:487-96.
27. 27. To T, Agha M, Dick PT, Feldman W. Cohort study on circumcision of newborn boys and subsequent risk of urinary tract infection. Lancet 1998; 352:1813-6.
28. 28. Wiswell TE, Smith FR, Bass JW. Decreased incidence of urinary tract infection in circumcised male infants. Pediatrics 1985; 75:901-3.
29. 29. Schoen E. The relationship between circumcision and cancer of the penis. CA Cancer J Clin 1994; 41:306-9.
30. 30. Van Howe RS, Svoboda JS, Dwyer JG, Pricce CP. Involuntary circumcision: the legal issues. BJU Int 1999; 83(suppl1): 63-73.
31. 31. Taylor JR., Lockwood AP. Taylor AJ. The prepuce: specialized mukosa of the penis and its loss to circumcision. Br J Urol 1996; 77:291-5.
32. 32. Speert H. Circumcision of the newborn; an appraisal of its present status. Obstet Gynecol 1953; 2:164-72.
33. 33. Patel H. The problem of routine circumcision. Can Med Assoc J 1966; 95: 576-81.
34. 34. Dunsmuir WD, Gorden EM. The history of circumcision. BJU Int. 1997:1-12.
35. 35. Byars LT, Trier WC. Some complications of circumcision and their surgical repair. Arch Surg 1958; 76: 477-82.
36. 36. Ben Chaim J, Livne PM, Binyamini J, Hardak B, Ben Meir D, Mor Y. Complications of circumcision in Israel: a one year multicenter survey. Isr Med Assoc J 2005; 7: 368-70.
37. 37. Raynor SC. Circumcisions. In: Ashcraft K, Murphy JP, eds. Pediatric surgery, 3rd ed. Philadelphia: W.B. Saunders; 2000. p.783-6.
38. 38. Campbell M, Walsh PC. Campbell’s Urology, 7th ed. Philadelphia: WB Saunders Company; 1998. p.1633.
39. 39. Leitch IO. Circumcision. A continuing enigma. Aust Paediatr J 1970; 6:59-65.
40. 40. Mirza FM. A study on complications of circumcision. Dissertation for fellowship CPSP 1992.
41. 41. Neulender E, Walfisch S, Kaneti J. Amputation of distal glans during neonatal ritual cir-cumcision-a rare complication. Br J Urol 1996;77: 924-5.
42. 42. Gluckman GR, Stoller ML, Jacobs MM. Newborn penile glans amputation during circumcision and successful reattachment. J Urol 1995;153:778-9.
43. 43. Dalens B, Hasnaoui A. Caudal anesthesia in pediatric surgery: success rate and adverse effects in 750 consecutive patients. Anesth Analg 1989;68:83-9.
44. 44. Ray M, Basu S.M. Postoperative analgesia in paediatric day case surgery. Update in Anaesthesia 12, Article 9, 2000. p.1-2.
45. 45. Serour F, Reuben S, Ezra S. Circumcision in children with penile block alone. J Urol 1995;153:474-6.
46. 46. Goulding FJ. Penile block for postoperative pain relief in penile surgery. J Urol 1981;126: 337-8.
47. 47. Sara CA, Lowry CJ. A complication of circumcision and dorsal nerve block of the penis. Anaesth Intensive Carel 985; 13:79-82.
48. 48. Burke D, Joypaul V, Thomson MF. Circumcision supplemented by dorsal penile nerve block with 0,75% ropivacaine: a complication. Reg Anesth Pain Med 2000;25:424-7.
49. 49. Tzeng YS, Tang SH, Meng E, Lin TF, Sun GH. Iscemic glans penis after circumcision. Asian J Androl 2004; 6:161-3.