Ahsaini M, Tazi F, Khalouk A, Lahlaidi K, Bouazzaoui A, Stuurman-Wieringa RE, Elfassi MJ, Farih MH. Bilateral testicular self-castration due to cannabis abuse: a case report.
J Med Case Rep 2011;
5:404. [PMID:
21861879 PMCID:
PMC3177921 DOI:
10.1186/1752-1947-5-404]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 08/23/2011] [Indexed: 11/25/2022] Open
Abstract
Introduction
The self-mutilating patient is an unusual psychiatric presentation in the emergency room. Nonetheless, serious underlying psychiatric pathology and drug abuse are important background risk factors. A careful stepwise approach in the emergency room is essential, although the prognosis, follow-up, and eventual rehabilitation can be problematic.
We present a unique and original case of bilateral self-castration caused by cannabis abuse.
Case Presentation
We report a case of a 40-year-old Berber man, who was presented to our emergency room with externalization of both testes using his long fingernails, associated with hemodynamic shock. After stabilization of his state, our patient was admitted to the operating room where hemostasis was achieved.
Conclusion
The clinical characteristics of self-mutilation are manifold and there is a lack of agreement about its etiology. The complex behavior associated with drug abuse may be one cause of self-mutilation. Dysfunction of the inhibitory brain circuitry caused by substance abuse could explain why this cannabis-addicted patient lost control and self-mutilated. To the best of our knowledge, this is the first case report which presents an association between self-castration and cannabis abuse.
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