Abstract
Introduction. Circumcision is a common procedure carried out around the world. Due to religious reasons, it is routinely done in Bangladesh, by both traditional as well as medically trained circumcisers. Complications include excessive bleeding, loss of foreskin, infection, and injury to the glans penis. Myiasis complicating male circumcision appears to be very rare. Case Presentation. In 2010, a 10-year-old boy presented to the OPD of Dhaka Medical College Hospital with severe pain in his penile region following circumcision 7-days after. The procedure was carried out by a traditional circumciser using unsterilized instruments and dressing material. After examination, unhealthy granulation tissue was seen and maggots started coming out from the site of infestation, indicating presence of more maggots underneath the skin. An emergency operation was carried out to remove the maggots and reconstruction was carried out at the plastic surgery department. Conclusion. There is scarcity of literature regarding complications following circumcision in developing countries. Most dangerous complications are a result of procedure carried out by traditional circumcisers who are inadequately trained. Incidence of such complications can be prevented by establishing a link between the formal and informal sections of healthcare to improve the safety of the procedure.
Highlights
Circumcision is a common procedure carried out around the world
We report a very rare complication following circumcision and the need for prevention of such cases to reduce the economical and psychological burden on the patients
There was some necrosed skin and multiple pockets containing maggots, some even extending to the mons pubis which made the exploration difficult. Some of these insects were removed by plane tissue forceps and some were treated with hydrogen peroxide to completely eradicate these pockets
Summary
Circumcision in Bangladesh is commonly conducted in neonates, infants, and children for religious reasons, in other parts of the world, it is carried out due to cultural influence and many are done for medical reasons. Circumcision being an operative procedure comes with its share of complications as well [2]. There have been reports of serious complications during the operation as well, such as excessive bleeding which has resulted in death and amputation of the glans penis [3]. The most common flies that cause the human infestation are Dermatobia hominis (human botfly) and Cordylobia anthropophaga(tumbu fly). These flies drop eggs containing larval stage on skin, wounds, or natural orifices of an immobile person, though recently described cases from many parts of the world have involved nasotrachea, mouth, brain, penis, gums, urinary bladder, and colon [6, 7]. We report a very rare complication following circumcision and the need for prevention of such cases to reduce the economical and psychological burden on the patients
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