A Case of Cut Throat and Penis

Aims: The management of cut throat injuries with genital self-mutilation is very challenging due to the complex anatomy of the neck and the need to attain acceptable cosmetic and functional outcomes of penile reconstruction. This report thus seeks to highlight the importance of a multidisciplinary approach to the management of these cases and to raise awareness of the need for early suspicion and diagnosis of mental diseases especially among young people.

Presentation of Case: We present an 18-year old newly diagnosed paranoid schizophrenic man who presented with cut throat and penis after an attempted suicide and was successfully managed at our facility. The family had not suspected any mental disorder. He had repair of the cut throat (involving both trachea and esophagus) after elective tracheostomy, refashioning of the penile stump and psychiatric treatment.

Discussion: Cut throat injuries happen in cases of attempted suicide and among patients with psychiatric problems. Cases of cut throat and genital self-mutilation though rare, have been reported among schizophrenics. Some of such individuals have an impression that destroying their genitals could help them overcome their excessive sexual desires and for others to help them remain righteous. Our patient was diagnosed of schizophrenia after he attempted suicide.

Conclusions: Young people with mental illness must be identified and given appropriate treatment early. Patients presenting with cut throat and penis require a multidisciplinary team approach involving at least an otorhinolaryngologist, a urologist, a general/gastrointestinal surgeon and a psychiatrist for optimum care.