ハエ蛆症を合併した自己陰茎切断の1例

Abstract

A 38-year-old male was admitted to our emergency ward on Oct. 27, 1982, because of severe pain at his penoscrotum. Upon physical finding on admission, his penis was found to have been completely amputated 2 cm distally near the root with a razor by himself to commit suicide a few days before admission. On the affected part were much coagulated blood mass and slough and moreover there were 50 maggots about 5 mm long swarming and wrigling, but no bleeding yet and little sign of inflammation. After exclusion of these maggots and cleaning the slashed surface, cutaneous urethrostomy was performed. Postoperative course was favorable but we could not prevent the patient from leaping to his death 45 days after the operation. Self-amputation of the penis with subsequent complication of myiasis is a very rare condition. Since the report of self-amputation of the penis by Matsushita in 1937, this case is the 16 th in Japan. In most cases the patients had mental disorder. In this case the patient was schizoid. On the other hand, 133 cases of myiasis were reported in Japan from 1903 to 1983. In the present case the species that caused myiasis was Lucilia ampullacea. A very rare case of self-amputation of the penis with subsequent complication of myiasis is documented with a review of the literature on this subject.