自傷による陰茎完全切断の1例

概要

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69歳男.血塗れで倒れているところを発見され,陰茎が切断され,左上肢も受傷していた.創部の応急処置を行い,患者の不穏が強いため,ハロペリドールを投与し,陰茎は低温保存した.左上肢は橈側浅指屈筋腱が断裂し,下腹部が著明に膨満,超音波で膀胱内に著明な尿貯留を認めた.尿閉に対し緊急に膀胱瘻を増設後,創部を処置した.自傷の可能性もあり,陰茎再吻合は困難と判断し,家族とも相談の上,断端形成術を施行した.創部の経過は良好で尿道の留置カテーテルは術後16日目に抜去した.自己陰茎切断症は極めて稀な疾患で,自験例を含め24例のみであるSelf-mutilation of the penis is extremely rare. A 69-year-old man was admitted after having amputated his own penis completely from its root. He had no history of psychiatric illness, but his physical condition on admission was abnormal. We performed urethrocutaneostomy, rather than replantation of the penis, because of the danger that he would reinjure himself. The patient was treated by a psychiatrist under a diagnosis of alcoholic dementia. To our knowledge, this is the 24th case of self-mutilation of the penis reported in the Japanese literature.