PMC5892274_01
Case 1: metal ring encircling phallus and scrotum.
CRIS2018-5216826.001.jpg
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fig1
On physical exam, the patient was found to have severe swelling of his penis and scrotum distal to the ring, which was placed at the base of these structures as seen in Figure 1.
Industrial grade steel bolt cutters.
CRIS2018-5216826.002.jpg
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fig2
Industrial bolt cutters (Figure 2) were obtained from the maintenance department and were used to cut the ring at the 12 and 6 o'clock position, allowing for removal of the ring.
PMC5892274_02
(a) Case 2: metal ring encircling phallus and scrotum. (b) Areas of significant necrosis seen along scrotum. (c) Metal ring disassembled with bolt cutters.
CRIS2018-5216826.003.jpg
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fig3
Severe swelling of the affected area was seen as shown in Figure 3(a). Due to the prolonged onset of presentation (>48 hours), necrosis of the scrotum could be seen as well, as demonstrated in Figure 3(b). The patient was taken emergently to the OR and had removal of the ring with the use of bolt cutters with cuts in two separate parts allowing for removal of the device (Figure 3(c)).