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Case Reports
. 2024 Jun 30;54(2):133-136.
doi: 10.28920/dhm54.2.133-136.

Hyperbaric oxygen treatment in bilateral orchiopexy and post-circumcision haematoma in a thrombocytopenic patient with Noonan syndrome

Dilşad Dereli  1   2 , Selahattin Çakiroğlu  3 , Ayse Aydan Köse  4 , Baran Tokar  1
Affiliations
Case Reports

Hyperbaric oxygen treatment in bilateral orchiopexy and post-circumcision haematoma in a thrombocytopenic patient with Noonan syndrome

Dilşad Dereli et al. Diving Hyperb Med. .

Abstract

Hyperbaric oxygen treatment (HBOT) can be utilised for necrotising soft tissue infections, clostridial myonecrosis (gas gangrene), crush injuries, acute traumatic ischaemia, delayed wound healing, and compromised skin grafts. Our case was a 17-month-old male patient with Noonan syndrome, idiopathic thrombocytopenic purpura, and bilateral undescended testicles. Haematoma and oedema developed in the scrotum and penis the day after bilateral orchiopexy and circumcision. Ischaemic appearances were observed on the penile and scrotal skin on the second postoperative day. Enoxaparin sodium and fresh frozen plasma were started on the recommendation of haematology. Hyperbaric oxygen treatment was initiated considering the possibility of tissue necrosis. We observed rapid healing within five days. We present this case to emphasise that HBOT may be considered as an additional treatment option in patients with similar conditions. To our knowledge, no similar cases have been reported in the literature.

Keywords: Case reports; Children; Haematology; Hyperbaric oxygenation; Injuries; Surgery.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Postoperative day one; haematoma initially appeared
Figure 2
Figure 2
Postoperative day two; progression to suspicious necrosis
Figure 3
Figure 3
Postoperative day three; first day of hyperbaric oxygen treatment
Figure 4
Figure 4
Postoperative day four and second day of hyperbaric oxygen treatment; a significant improvement was observed in the haematoma
Figure 5
Figure 5
Postoperative day five and third day of hyperbaric oxygen treatment
Figure 6
Figure 6
Postoperative day six and fourth day of hyperbaric oxygen treatment
Figure 7
Figure 7
Postoperative day seven and fifth day of hyperbaric oxygen treatment
Figure 8
Figure 8
Postoperative day eight; complete resolution of haematoma was achieved
See this image and copyright information in PMC

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