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[A case of priapism caused by disseminated intravascular coagulopathy]
Insights
This case study describes priapism caused by disseminated intravascular coagulopathy (DIC). Pathological findings confirmed DIC as the cause, a first reported in Japan, and treatment involved FOY and heparin.
Area of Science:
- Urology
- Hematology
- Pathology
Background:
- A 72-year-old male with bronchitis and liver cirrhosis presented with fever and cough.
- The patient developed purpura, edema, and pain on extremities, followed by priapism.
Observation:
- Priapism developed a week after the onset of purpura.
- Despite interventions like irrigation, aspiration, and fistula creation, penile necrosis occurred.
- Penile amputation was necessary due to irreversible necrosis.
Findings:
- Pathological examination of the amputated penis and skin biopsy confirmed disseminated intravascular coagulopathy (DIC) as the cause of priapism.
- Blood coagulation tests supported the diagnosis of DIC.
- The patient's DIC was successfully managed with FOY (Futhan) and heparin therapy.
Implications:
- This case highlights a rare presentation of priapism secondary to DIC.
- It underscores the importance of pathological diagnosis in complex cases.
- Effective management of DIC with anticoagulants can be crucial in preventing severe complications like penile necrosis.
Abstract:
A case is presented of priapism resulting from disseminated intravascular coagulopathy (DIC), which was diagnosed by pathological studies of the amputated penis and skin biopsy. To our knowledge, this is the first case reported in Japan. This 72-year-old-man visited a hospital complaining of fever and cough, and was administrated for treatment of bronchitis and liver cirrhosis. A few days after admission, multiple purpura with edema and pain appeared over the skin regions on the bilateral knee joint, foot joint and upper extremities. A week after purpura appeared, priapism began. Regardless of irrigation and aspiration of corpora cavernosa and glans-cavernosa-fistula creation, penile necrosis developed. We had to perform penile amputation. The pathology of the amputated penis and skin, and blood coagulative examination suggested that DIC resulted in priapism. DIC was controllable by the use of FOY and heparin. He was discharged and is an outpatient.