Answer for BIR CoW 26 Aug 2018
Penile intracavernosal hematoma
Findings
Intracavernosal hematoma Corpus spongiosum normal Tunica albuginea intact No evidence of urethral injury Impression - Intracavernosal hematoma without tear of the tunica albuginea.
Discussion
H/o injury to penis during sexual intercourse x 5 Days back Complaints of passage of blood through EUM C/O Pain over urethra + MRI Shows penis Intracavernosal hematoma without tear of the tunica albuginea. MR Imaging of Acute Penile Fracture Penile fracture is a rare but serious urologic condition that typically requires surgical repair. MR imaging can accurately depict the presence, location, and extent of tunical tear, which manifests as discontinuity of the tunica albuginea. the tunica albuginea is well demonstrated as a low-signal-intensity structure on both T1- and T2-weighted images MR imaging can demonstrate an intact tunica albuginea and the presence of intracavernosal or extratunical hematoma. Surgical repair is generally recommended for patients with a suspected tear of the tunica albuginea or urethral injury. Penile or scrotal hematoma was better demonstrated at T2-weighted MR imaging than at contrast-enhanced T1-weighted imaging Clinical Manifestations An audible crack, sudden onset of pain, immediate loss of erection, rapid swelling, widespread ecchymosis, and deviation toward the side opposite the injury The fracture usually occurs unilaterally in the distal two-thirds of the penis and typically involves less than one-half of the cavernosal circumference . When present, a hematoma is usually confined to the penis but extend to the scrotum, perineum, and thighs. Hematuria or dysuria with associated urethral injury. Things to report In a case of penile injury Integrity of the Tunica Albuginea - The tear appeared as discontinuity of the lowsignal-intensity tunica albuginea Extent and Location of Tunical Tear Urethral and Spongiosal Involvement The presence of urethral or spongiosal involvement is of great importance because it necessitates urgent surgical intervention
Findings
Intracavernosal hematoma Corpus spongiosum normal Tunica albuginea intact No evidence of urethral injury Impression - Intracavernosal hematoma without tear of the tunica albuginea.
Discussion
H/o injury to penis during sexual intercourse x 5 Days back Complaints of passage of blood through EUM C/O Pain over urethra + MRI Shows penis Intracavernosal hematoma without tear of the tunica albuginea. MR Imaging of Acute Penile Fracture Penile fracture is a rare but serious urologic condition that typically requires surgical repair. MR imaging can accurately depict the presence, location, and extent of tunical tear, which manifests as discontinuity of the tunica albuginea. the tunica albuginea is well demonstrated as a low-signal-intensity structure on both T1- and T2-weighted images MR imaging can demonstrate an intact tunica albuginea and the presence of intracavernosal or extratunical hematoma. Surgical repair is generally recommended for patients with a suspected tear of the tunica albuginea or urethral injury. Penile or scrotal hematoma was better demonstrated at T2-weighted MR imaging than at contrast-enhanced T1-weighted imaging Clinical Manifestations An audible crack, sudden onset of pain, immediate loss of erection, rapid swelling, widespread ecchymosis, and deviation toward the side opposite the injury The fracture usually occurs unilaterally in the distal two-thirds of the penis and typically involves less than one-half of the cavernosal circumference . When present, a hematoma is usually confined to the penis but extend to the scrotum, perineum, and thighs. Hematuria or dysuria with associated urethral injury. Things to report In a case of penile injury Integrity of the Tunica Albuginea - The tear appeared as discontinuity of the lowsignal-intensity tunica albuginea Extent and Location of Tunical Tear Urethral and Spongiosal Involvement The presence of urethral or spongiosal involvement is of great importance because it necessitates urgent surgical intervention
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!