We present the case of a 25-year-old male who came to the emergency room for pain and abdominal distension following trauma to the mesogastrium. A CT scan was performed, revealing a voluminous retroperitoneal hematoma with laceration of both inferior renal poles with regard to rupture of the isthmus of a horseshoe kidney. The patient presented anemization and increased pain, requiring selective embolization by means of arteriography of a branch of the right renal artery and placement of a double J stent due to urinary extravasation in the lower left kidney pole. Following 1 year of monitoring, the patient has maintained normal renal function. Renal affection in blunt abdominal trauma is frequent, occurring in 7% of previously pathological kidneys. The traumatic rupture of horseshoe kidney is facilitated by its particular anatomical characteristics, constituting an infrequent entity, knowledge of which is necessary to achieve conservative management that renders it possible to preserve renal function.
Mondor's syndrome is an infrequent condition usually caused by trauma, though it is important to consider the possibility of associated coagulation problems, infections and neoplastic processes. Doppler ultrasound is the technique of choice for confirming the diagnosis and resolution of the condition. Treatment is based on nonsteroidal antiinflammatory medication, antibiotherapy and sexual abstinence. The use of anticoagulation is controversial, but may prove useful in patients with coagulation disorders.
Presentación de casos clínicos RESUMENEl priapismo arterial es una rara patología en pacientes pediátricos, originada por una fístula entre la arteria cavernosa y los sinusoides del cuerpo cavernoso, habitualmente secundaria a un traumatismo perineal. Presentamos el caso de un varón de 16 años con priapismo arterial de 5 días de evolución tras una caída a horcajadas, tratado satisfactoriamente mediante embolización arterial supraselectiva con material reabsorbible. Seis meses después, el paciente presenta detumescencia completa sin disfunción eréctil asociada. La embolización arterial en pacientes pediátricos es compleja debido al menor calibre arterial y la necesidad de control de la arteria pudenda interna contralateral para evitar el desarrollo de complicaciones. La utilización de material reabsorbible permite disminuir el riesgo de disfunción eréctil posterior y, aunque presenta un mayor índice de recurrencias, constituye una alternativa eficaz en el tratamiento de esta patología. Palabras clave: priapismo arterial, embolización terapeútica, disfunción eréctil.
ABSTRACTArterial priapism is a rare condition in pediatric patients, caused by a fistula between the cavernous artery and the sinusoids of the corpus cavernosum, usually secondary to perineal trauma. We report the case of a 16 year old child with arterial priapism of 5 days duration following a fall astride, successfully treated by superselective arterial embolization with absorbable material. Six months later the patient had complete detumescence without secondary erectile dysfunction. Arterial embolization in pediatric patients is complex due to the smaller arterial size and the need to control the contralateral internal pudendal artery to prevent the development of complications. The use of absorbable material helps reduce the risk of subsequent erectile dysfunction and, although it has Priapismo de alto flujo postraumático en paciente pediátrico tratado con embolización arterial selectiva Postraumatic high-flow priapism in pediatric patient treated with selective arterial embolization a higher rate of recurrence, is an alternative for the treatment of this pathology.
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