Priapismus as a Rare Manifestation of Leukemia in Children and Delay of Medical Help Seeking due to Local Value in Indonesia’s Society

Abstract:

Priapismus is the erection of penis without sexual stimulation that could happens due to blood abnormality, trapped in penis vessel, such as leukemia disease. Priapismus is rarely seen in leukemia, especially in Indonesia. However, as a developing country, there is another problem because of low education, awareness and cultural background. The society has local values or believes which make the patient tend to hide this complain. Therefore, numerous cases of priapismus are neglected or ignored by the patient or family. This condition results delay in diagnosis, treatment and increase the complication of priapismus or underlying disease. In this study, We report a 12 years old children in emergency ward presenting painful persistent priapismus for over 24 hours. History of priapismus of the patient is present in last 4 months, with no other complain, medical history and no family history of the same symptom. Leukocytosis, thrombocytosis and mild anemia were found in Blood Test. Complication of penis tissue ischemia was found from Dorsal Penis Artery Blood Gas Analysis.  Irrigation was performed by urologist in emergency ward to prevent complication. Bone marrow aspiration confirmed of Chronic Myeloid Leukemia. We also present the social value that effect this patient’s medical decision. From this paper, we conclude that physicians must be aware about priapismus symptom and the probability of differential diagnosis. A serious disease such as leukemia could be shown with no systemic and typical symptom, like in this case. We must concur that the public must be educated that such symptoms are not a disgrace and not correlated with local social value. Therefore, the delay getting medical care could be prevented.

What will audience learn from your presentation?

• Manifestation of priasmus and it’s differential diagnosis
• Pathophysiology of priapismus in Leukemia
• Management and complication of priapismus
• Social value in Indonesia as a developing country that makes patient with priapismus delay to seek medical service

Biography:

Dr. Annisa Bunga Nafara is a Emergency General Practitioner, in Fatmawati Central general Hospital in Jakarta, Indonesia. She studied medicine in Muhammadiyah Malang Medical Faculty and graduated as a Medical Doctor in April 2020. After 1,5 years in clinical practice, She then applied in Fatmawati Central General Hospital as the volunteer Doctor in the Covid Pandemic. Now she is working in emergency department.  Currently, dr. Annisa continue her study for master degree of Medical Education in University of Indonesia.