| Author | Affiliation |
|---|---|
| Sow A. Kobayashi, MD | University of California, San Diego, Department of Emergency Medicine, La Jolla, California; University of California, San Diego, Department of Pediatrics, La Jolla, California |
| Erica F. Sanford, MD | University of California, San Diego, Department of Emergency Medicine, La Jolla, California; University of California, San Diego, Department of Pediatrics, La Jolla, California |
| Peter Witucki, MD | University of California, San Diego, Department of Emergency Medicine, La Jolla, California; University of California, San Diego, Department of Pediatrics, La Jolla, California |
A healthy, uncircumcised 34-year-old male presented to an emergency department (ED) in Tinian (Commonwealth of the Northern Mariana Islands) after a parrot fish bite. The patient was spearfishing in the Philippine Sea and impaled a 15-pound parrot fish. As the patient was attempting to grasp the speared fish it bit him in the groin exterior to his swimming trunks. He experienced immediate penile pain and swam back to shore. Upon removal of his intact swimming trunks, the patient noticed a two-centimeter foreskin avulsion at the proximal penile shaft (picture). He presented to the ED where extensive irrigation of the wound with normal saline was initiated, followed by administration of local anesthesia and laceration repair with sutures. The patient was offered systemic analgesics but declined. He received tetanus toxoid immunization and was discharged with an antibiotic prescription for skin and marine flora with instructions to follow up in one week. The patient was contacted 10 weeks later for follow-up and stated that the avulsion healed well with good comesis and he has had no infections or issues with urination or erections.
Figure. Penile foreskin avulsion from parrot fish bite.
Footnotes
Section Editor: Dr. Sean O. Henderson, MD
Full text available through open access at http://escholarship.org/uc/uciem_westjem
Address for Correspondence: Sow Kobayashi, MD, 200 West Arbor Dr., MC #8676, San Diego, CA 92103 Email: s2kobayashi@ucsd.edu. 3 / 2015; 16:320 – 320
Submission history: Revision received January 3, 2015; Accepted January 21, 2015
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.
