Successful Treatment With Enoxaparin of Glans Ischemia Due to Local Anesthesia After Circumcision

Efe E., Resim S., Bulut B. B. , Eren M., Garipardic M., Ozkan F., ...More

PEDIATRICS, vol.131, no.2, 2013 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 131 Issue: 2
  • Publication Date: 2013
  • Doi Number: 10.1542/peds.2012-1400
  • Title of Journal : PEDIATRICS


The severe ischemia or necrosis of the glans penis is a rarely seen complication after circumcision. We report the case of a 7-year-old boy with severe glans penis ischemia occurring 24 hours after circumcision with local anesthesia (0.1% xylocaine containing ephedrine). His hemogram and levels of proteins C and S and fibrinogen were normal, but the D-dimer level was higher than normal (2.57 mg/L; normal level 0-0.5 mg/L). Normal blood flow was indicated on color Doppler ultrasonography. The severe ischemia in the glans penis was successfully treated with subcutaneous injection of enoxaparin (low-molecular-weight heparin) for 5 days, and the appearance of the glans was close to normal on the fifth day. The patient did not require any surgical intervention and was discharged without sequelae. As a result, we consider that ischemia of the glans penis may initially be managed with enoxaparin, especially in cases in which the D-dimer level is higher than normal. Pediatrics 2013; 131: e608-e611