When zippers attack: the first documented case of penile zipper entrapment requiring emergency circumcision in a resource-limited setting

Abstract

Penile zipper injuries are relatively common in pediatric patients; however, most are successfully managed conservatively. These injuries typically occur when the foreskin or penile shaft becomes entrapped within the zipper mechanism and are most frequently reported in children aged two to twelve years. While most cases are amenable to conservative management, a subset requires surgical intervention. We present a case of a 10-year-old boy with severe penile zipper entrapment that necessitated emergency circumcision following unsuccessful attempts at conservative mechanical release A non-circumcised 10-year-old boy presented to the Emergency Department after entrapping his penile skin in the zipper of his trousers while dressing. On examination, 4 cm of the dorsal skin was caught, resulting in anxiety, pain, and minor bleeding. Despite attempts to free the tissue using local anesthesia and lubricants, surgical intervention became necessary. Penile zipper entrapment is an uncommon but potentially distressing injury in children. While most cases can be managed conservatively, emergency circumcision may be required when standard release techniques fail, particularly in resource-limited settings. This case contributes to the limited literature on operative management of penile zipper injuries and underscores the importance of prompt intervention and appropriate family counselling.