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| LETTER TO EDITOR |
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| Year : 2022 | Volume
: 17
| Issue : 1 | Page : 211-212 |
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Postintercourse extraalbugineal penile hematoma: Ultrasound and elastography appearance
Nishant Raj, Suresh Vasant Phatak, Shivesh Pandey, Vaishali Bodhraj Dhawan, Roohi Gupta
Department of Radiodiagnosis, AVBRH Hospital, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
| Date of Submission | 20-Jul-2021 |
| Date of Decision | 08-Jan-2022 |
| Date of Acceptance | 18-Feb-2022 |
| Date of Web Publication | 25-Jul-2022 |
Correspondence Address:
Dr. Suresh Vasant Phatak
Department of Radiodiagnosis, AVBRH Hospital, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdmimsu.jdmimsu_279_21
How to cite this article:
Raj N, Phatak SV, Pandey S, Dhawan VB, Gupta R. Postintercourse extraalbugineal penile hematoma: Ultrasound and elastography appearance. J Datta Meghe Inst Med Sci Univ 2022;17:211-2 |
Sir,
We present a case of a 45-year-old man who presented with chief complaint of mild pain and swelling over the shaft of the penis for the past 18 days, he gave preceding history of sexual intercourse after that swelling appeared. There was no history of any other penetrating/blunt trauma. Bowel/bladder habits were normal. On palpation, the swelling was nodular, nontender with no signs of inflammation. Transverse sonogram of penis image reveals a large, irregularly defined hypoechoic area anterior to the left corpora cavernosa with no break in tunica albuginea. There was no associated urethral rupture in this case. On elastography, blue-green-red (BGR) pattern was seen confirming the presence of a predominately cystic lesion.
Penile trauma is a relatively rare condition wherein patients typically present with clinical history pointing toward the diagnosis, but a definitive diagnosis solely based on history is often not possible, imaging techniques particularly sonography helps in establishing the diagnosis and helps us delineate the anatomy, location, nature, and extent of injury. Furthermore, penile vasculature can be assessed using Doppler.[1] Penile trauma can be either penetrating or blunt trauma; the ones with penetrating injury rarely need any imaging as surgical exploration is often needed. Blunt traumatic injuries to the penis usually happen when the penis is erect and is exposed to lateral bending forces. Penile fracture is the most common blunt traumatic injury, wherein there is a tear in the tunica albuginea which results in rupture of one or both corpora cavernosa. Patients with penile fracture typically give history of rapid detumescence with pain and swelling. Often there is an antecedent history of vigorous sexual intercourse. In about 10%–20% of patients with penile fracture there is often a concomitant urethral injury.[2] Another form of blunt traumatic injury is intracavernosal hematoma without penile fracture. This typically results due to injury of subtunical venous plexus and/or smooth muscle trabeculae without a tear in tunica albuginea.[1] The third form of blunt trauma injury is extraalbugineal hematoma wherein the blood collects in subepithelial connective tissue, i.e., the space between Buck's fascia and Colles' fascia [Figure 2] and [Figure 3].[3] On elastography, cysts usually show a “bull's eye” artifact on black-and-white images and an aliasing artifact, the BGR pattern, on color-coded images [Figure 1].[4] | Figure 1: Elastography reveals blue green red pattern consistent with predominantly cystic lesion
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 | Figure 2: Transverse gray scale sonogram slightly caudal to the longitudinal image reveals a large, irregularly defined hypo-echoic area anterior to left corpora cavernosa
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 | Figure 3: Longitudinal gray scale sonogram of the penis shows a hypoechoic area near the base of the penis anterior to the left corpora cavernosa
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Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Bhatt S, Kocakoc E, Rubens DJ, Seftel AD, Dogra VS. Sonographic evaluation of penile trauma. J Ultrasound Med 2005;24:993-1000.  |
| 2. | Avery LL, Scheinfeld MH. Imaging of penile and scrotal emergencies. Radiographics 2013;33:721-40. |
| 3. | Bertolotto M, Mucelli RP. Nonpenetrating penile traumas: Sonographic and Doppler features. AJR Am J Roentgenol 2004;183:1085-9. |
| 4. | Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, et al. Breast disease: Clinical application of US elastography for diagnosis. Radiology 2006;239:341-50. |
[Figure 1], [Figure 2], [Figure 3]
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