Case Report
Genital Self-Mutilation in a Young Nigerian Man: A Case of Klingsor Syndrome
Issue:
Volume 13, Issue 2, April 2025
Pages:
37-40
Received:
13 February 2025
Accepted:
28 February 2025
Published:
18 March 2025
Abstract: We present an uncommon case of genital mutilation in a 24 year old Nigerian man who presented to the Accident and Emergency Wing of our hospital on account of self-inflicted complete penile amputation and scrotal avulsion injury without the amputated stump, following an episode of auditory hallucination. There was a background history of substance abuse. He had initial resuscitation with intravenous fluid and a pint of blood transfused on account of low hematocrit. He was equally evaluated by the Mental Health Physician at presentation. The wound was packed with saline soaked gauze for further exploration in the operating room. Tetanus injection was administered. Intra – operatively under regional anesthesia, wound exploration, thorough irrigation with saline and wound debridement was done with findings of penile stump exposing the cavernous body and urethra, as well as the testes in situ. A stump refashioning using the scrotal skin flap was done and a neo-urethral created with the use of absorbable vicryl 3/0 sutures. The wound healed satisfactorily, voiding per urethra and was discharged on day 10 after surgery. This report reveals refashioning of the stump as a viable treatment option using a scrotal skin flap in the absence of an amputated stump or facility for micro vascular repair. It also points out this syndrome as one of the rare complication of drug induced psychosis.
Abstract: We present an uncommon case of genital mutilation in a 24 year old Nigerian man who presented to the Accident and Emergency Wing of our hospital on account of self-inflicted complete penile amputation and scrotal avulsion injury without the amputated stump, following an episode of auditory hallucination. There was a background history of substance ...
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Research Article
The Role of Early Repeat CT Imaging in Traumatic Brain Injury
Issue:
Volume 13, Issue 2, April 2025
Pages:
41-44
Received:
6 April 2025
Accepted:
17 April 2025
Published:
19 May 2025
Abstract: Background: Routine repeat CT head imaging of trauma patients with Traumatic Brain Injury (TBI) within 24 hours has been a standard of practice. However, the literature does not show the optimal timing of these repeat CT scans to determine need for neurosurgical intervention. The objective of our study is to determine the optimal timing of routine repeat head CTs (CTH) in patients with TBI to assess for progression of injury and determine need for neurosurgical intervention. We hypothesized that patients with a change in Glasgow coma scale (GCS) receiving repeat CTH would show progression and a higher rate of neurosurgical intervention. Methods: Retrospective study was performed at a level 2 trauma center and included patients from January 2020 to January 2022. All patients diagnosed with a TBI on initial CTH who did not undergo immediate neurosurgical intervention and underwent a repeat interval CTH were included. Univariate analysis was used to assess patients who underwent intervention vs those who did not to compare the role of early repeat CT imaging. Results: 560 patients fulfilled inclusion criteria. 15 patients (2.7%) required neurosurgical intervention after repeat imaging. There was a significantly higher proportion of interval repeat CTH performed early (within 12 hours) in patients ultimately undergoing neurosurgical intervention compared with those that did not (0.80 vs 0.473, p=0.0165). The patients taken for intervention after repeat imaging had a significantly higher ISS (p= 0.0001) and tended to have a lower GCS on admission (p=0.0573). Conclusion: These findings suggest that there is value in obtaining early repeat CTH (< 12 hours) in carefully selected populations that may include more injured patients or patients with a lower admission GCS. However, identification of this high-risk population requires further analysis.
Abstract: Background: Routine repeat CT head imaging of trauma patients with Traumatic Brain Injury (TBI) within 24 hours has been a standard of practice. However, the literature does not show the optimal timing of these repeat CT scans to determine need for neurosurgical intervention. The objective of our study is to determine the optimal timing of routine ...
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Sunday Olurotimi Ogundiniyi
