EURORAD ESR

Case 15317

Traumatic priapism

Author(s)
Dr. Matton Tom, Dr. Vanhoutte Els

University Hospitals Leuven,
Herestraat 49,
3000 Leuven,
Belgium
 
Patient
male, 35 year(s)
 
 
  • Figure 1
    Longitdunal section B-Mode and Color mode
     

    Longitudinal B-Mode image of left corpus cavernosum at the base of the penis: sharply defined hyporeflective cavity surrounded by dilated venous sinusoids

     
    Area of Interest: Emergency; Genital / Reproductive system male; Trauma; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Cavitation; Trauma;

    Color Mode shows turbulent flow in this hyporeflective cavity with aliaising.

     
    Area of Interest: Emergency; Genital / Reproductive system male; Trauma; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Blood; Fistula; Trauma;

    Transverse 'virtual convex' image through the base of the penis better depicts the asymmetric cavity in the left corpus cavernosum

     
    Area of Interest: Emergency; Genital / Reproductive system male; Trauma; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Cavitation; Trauma;
     
     
  • Figure 2
    Axial image with fistula in Color and Spectral mode
     

    Transverse image of left corpus cavernosum. Color Doppler shows a high-flow fistula arising from the cavernosal artery with aliaising.

     
    Area of Interest: Arteries / Aorta; Emergency; Genital / Reproductive system male; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Fistula; Haemorrhage; Trauma;

    Spectral Doppler shows persistant turbulent forward flow with high PSV (>200mm/s) and forward EDV.

     
    Area of Interest: Arteries / Aorta; Emergency; Genital / Reproductive system male; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Diagnostic procedure; Special Focus: Fistula; Haemorrhage; Trauma;
     
     
  • Figure 3
    Axial bi-cavernosal image with dilated venous sinusoids

    Dilated venous sinusoids are seen as in normal penile erection

     
    Area of Interest: Emergency; Genital / Reproductive system male; Trauma; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 4
    Follow-up ultrasound after 2 months
     

    Transverse image through the base of the penis showing a decreased diameter of the cavity (7mm).

     
    Area of Interest: Emergency; Genital / Reproductive system male; Trauma; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Cavitation; Trauma;

    Transverse Color Doppler image with persistent turbulent flow with aliaising in the fistula.

     
    Area of Interest: Arteries / Aorta; Emergency; Genital / Reproductive system male; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Fistula; Trauma;

    Spectrale Doppler curve with gate position as showed in fig. 4b. The same low resistance pattern is seen as in fig. 2b but with decreased PSV of 49mm/s.

     
    Area of Interest: Arteries / Aorta; Emergency; Genital / Reproductive system male; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Diagnostic procedure; Special Focus: Fistula; Haemodynamics / Flow dynamics; Trauma;
     
     
  • Figure 5
    Follow-up ultrasound after 5 months
     

    Longitudinal image of the left corpus spongiosum and the fistula after 5 months. Turbulent flow with aliaising is still observed.

     
    Area of Interest: Arteries / Aorta; Emergency; Genital / Reproductive system male; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Cavitation; Fistula; Haemorrhage;

    Spectral Doppler curve with gate positioned as showed in fig. 5a. A similar low resistance pattern is still seen, PSV has further decreased to about 30mm/s.

     
    Area of Interest: Arteries / Aorta; Emergency; Genital / Reproductive system male; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Diagnostic procedure; Special Focus: Fistula; Haemodynamics / Flow dynamics; Haemorrhage;
     
     
Longitudinal B-Mode image of left corpus cavernosum at the base of the penis: sharply defined hyporeflective cavity surrounded by dilated venous sinusoids
 
Color Mode shows turbulent flow in this hyporeflective cavity with aliaising.
 
Transverse 'virtual convex' image through the base of the penis better depicts the asymmetric cavity in the left corpus cavernosum
 
Transverse image of left corpus cavernosum. Color Doppler shows a high-flow fistula arising from the cavernosal artery with aliaising.
 
Spectral Doppler shows persistant turbulent forward flow with high PSV (>200mm/s) and forward EDV.
 
Dilated venous sinusoids are seen as in normal penile erection
 
Transverse image through the base of the penis showing a decreased diameter of the cavity (7mm).
 
Transverse Color Doppler image with persistent turbulent flow with aliaising in the fistula.
 
Spectrale Doppler curve with gate position as showed in fig. 4b. The same low resistance pattern is seen as in fig. 2b but with decreased PSV of 49mm/s.
 
Longitudinal image of the left corpus spongiosum and the fistula after 5 months. Turbulent flow with aliaising is still observed.
 
Spectral Doppler curve with gate positioned as showed in fig. 5a. A similar low resistance pattern is still seen, PSV has further decreased to about 30mm/s.
 
 
 
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