自己去勢の1例

Abstract

22歳男.15歳時よりうつ病, 脅迫神経症の診断で精神科病院にてカウンセリングを受けていた.陰嚢が紫色に壊死していると錯覚し, 自宅トイレで彫刻刀を用い陰嚢を切除し, 更に両側の精巣を切除しトイレに破棄した.出血が止まらないため, 受診した.顔面はやや蒼白の感があるが, 平静な顔貌で, 眼瞼結膜に貧血を認めず, 又, 疼痛も一切訴えなかった.止血と閉創のため手術を施行した.陰嚢皮膚は殆どない状態で, 両側の精巣は認められず, 精索血管及び精管は切断されていた.術創は, 著変なく治癒した.術後に, 精神科医の診断を受けたが, 忘想型精神分裂病と診断され, 今後精神的管理を続ける必要があるとのコメントであった.現在, 精神科医で精神的管理を続行中である

A 22-year old man was admitted to the emergency room of our hospital with bleeding from scrotal wound. He had resected his own scrotum and both testes by himself with a small knife, since he thought that his testes had developed necrosis. He had thrown his scrotal skin and both testes away in a lavatory. We closed the wide wound surface and the surrounding skin after ligation of the spermatic cord. The post-operative course was uneventful. The patient was referred to the psychiatric department of our hospital and received supportive psychotherapy under diagnosis of schizophrenia. This is the 23rd case to be reported as self-injury of the external genitalia and the 7th case limited to testis in the Japanese literature.