{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:15:00Z","timestamp":1787022900579,"version":"build-2736575974"},"reference-count":12,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:p>The severe ischemia or necrosis of the glans penis is a rarely seen complication after circumcision. We report the case of a 7-year-old boy with severe glans penis ischemia occurring 24 hours after circumcision with local anesthesia (0.1% xylocaine containing ephedrine). His hemogram and levels of proteins C and S and fibrinogen were normal, but the D-dimer level was higher than normal (2.57 mg\/L; normal level 0\u20130.5 mg\/L). Normal blood flow was indicated on color Doppler ultrasonography. The severe ischemia in the glans penis was successfully treated with subcutaneous injection of enoxaparin (low-molecular-weight heparin) for 5 days, and the appearance of the glans was close to normal on the fifth day. The patient did not require any surgical intervention and was discharged without sequelae. As a result, we consider that ischemia of the glans penis may initially be managed with enoxaparin, especially in cases in which the D-dimer level is higher than normal.<\/jats:p>","DOI":"10.1542\/peds.2012-1400","type":"journal-article","created":{"date-parts":[[2013,1,14]],"date-time":"2013-01-14T23:03:48Z","timestamp":1358204628000},"page":"e608-e611","source":"Crossref","is-referenced-by-count":20,"title":["Successful Treatment With Enoxaparin of Glans Ischemia Due to Local Anesthesia After Circumcision"],"prefix":"10.1542","volume":"131","author":[{"given":"Erkan","family":"Efe","sequence":"first","affiliation":[{"name":"Departments of Urology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sefa","family":"Resim","sequence":"additional","affiliation":[{"name":"Departments of Urology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak Besir","family":"Bulut","sequence":"additional","affiliation":[{"name":"Departments of Urology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Eren","sequence":"additional","affiliation":[{"name":"Department of Urology, Kahramanmaras State Hospital, Kahramanmaras, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mesut","family":"Garipardic","sequence":"additional","affiliation":[{"name":"Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuat","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keramettin Ugur","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,2,1]]},"reference":[{"issue":"2","key":"2021120903275535700_B1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/0253-7184.74967","article-title":"Circumcision.","volume":"31","author":"Puri","year":"2010","journal-title":"Indian J Sex Transm Dis"},{"issue":"2","key":"2021120903275535700_B2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/jcu.20271","article-title":"Postcircumcision necrosis of the glans penis: gray-scale and color Doppler sonographic findings.","volume":"35","author":"Barnes","year":"2007","journal-title":"J Clin Ultrasound"},{"issue":"4","key":"2021120903275535700_B3","first-page":"424","article-title":"Circumcision supplemented by dorsal penile nerve block with 0.75% ropivacaine: a complication.","volume":"25","author":"Burke","year":"2000","journal-title":"Reg Anesth Pain Med"},{"issue":"6","key":"2021120903275535700_B4","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/S0022-5347(17)49371-2","article-title":"Penile tourniquet injury due to a coil of hair.","volume":"133","author":"Sheinfeld","year":"1985","journal-title":"J Urol"},{"issue":"2","key":"2021120903275535700_B5","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/00006534-198108000-00022","article-title":"Necrosis of the glans penis following neonatal circumcision.","volume":"68","author":"Sterenberg","year":"1981","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"2021120903275535700_B6","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1542\/peds.103.3.686","article-title":"Circumcision policy statement.","volume":"103","author":"American Academy of Pediatrics, Task Force on Circumcision","year":"1999","journal-title":"Pediatrics"},{"issue":"6","key":"2021120903275535700_B7","first-page":"309","article-title":"A complication associated with dorsal penile nerve block.","volume":"15","author":"Berens","year":"1990","journal-title":"Reg Anesth"},{"issue":"13","key":"2021120903275535700_B8","doi-asserted-by":"crossref","first-page":"2878","DOI":"10.1182\/blood-2008-06-165845","article-title":"D-dimer antigen: current concepts and future prospects.","volume":"113","author":"Adam","year":"2009","journal-title":"Blood"},{"issue":"2","key":"2021120903275535700_B9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.lab.2004.04.006","article-title":"Low molecular weight heparin (dalteparin) is equally effective as unfractionated heparin in reducing coagulation activity and perfusion abnormalities during the early treatment of pulmonary embolism.","volume":"144","author":"Schutgens","year":"2004","journal-title":"J Lab Clin Med"},{"issue":"6","key":"2021120903275535700_B10","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1046\/j.1440-1754.2002.00052.x","article-title":"Low molecular weight heparin for neonatal thrombosis.","volume":"38","author":"Shama","year":"2002","journal-title":"J Paediatr Child Health"},{"issue":"7","key":"2021120903275535700_B11","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/j.1442-2042.2005.01129.x","article-title":"Severe ischemia of the glans penis following circumcision: a successful treatment via pentoxifylline.","volume":"12","author":"Aslan","year":"2005","journal-title":"Int J Urol"},{"issue":"1","key":"2021120903275535700_B12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1177\/0310057X8501300111","article-title":"A complication of circumcision and dorsal nerve block of the penis.","volume":"13","author":"Sara","year":"1985","journal-title":"Anaesth Intensive Care"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/131\/2\/e608\/1089320\/peds_2012-1400.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/131\/2\/e608\/1089320\/peds_2012-1400.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T13:20:44Z","timestamp":1639056044000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/131\/2\/e608\/31935\/Successful-Treatment-With-Enoxaparin-of-Glans"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,1]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2013,2,1]]},"published-print":{"date-parts":[[2013,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2012-1400","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,1]]}}}