Anticoagulant-induced priapism progressing to penile gangrene: a devastating complication!

BMJ Case Rep. 2012 Nov 21:2012:bcr2012007073. doi: 10.1136/bcr-2012-007073.

Abstract

A 35-year-old man developed priapism with the use of low-molecular-weight heparin and warfarin following repair of left brachial artery sustained after gunshot injury. Priapism progressed to penile gangrene despite decompression and distal shunt procedure leading to total penectomy and perineal urethrostomy. We describe the mechanism of anticoagulant (heparin and warfarin)-induced penile gangrene and the possible methods to avert such a devastating complication.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Brachial Artery / injuries
  • Brachial Artery / surgery
  • Dalteparin / adverse effects*
  • Dalteparin / therapeutic use
  • Drug Therapy, Combination
  • Gangrene
  • Hemopneumothorax / surgery
  • Humans
  • International Normalized Ratio
  • Male
  • Penis / pathology*
  • Penis / surgery
  • Perineum / surgery
  • Postoperative Care
  • Postoperative Complications / drug therapy
  • Priapism / chemically induced*
  • Priapism / diagnosis
  • Priapism / surgery
  • Saphenous Vein / transplantation
  • Thrombosis / surgery
  • Ultrasonography, Doppler, Color
  • Urethra / surgery
  • Warfarin / adverse effects*
  • Warfarin / therapeutic use
  • Wounds, Gunshot / surgery

Substances

  • Anticoagulants
  • Warfarin
  • Dalteparin