[Spontaneous autoembolization in a child with high-flow post-traumatic priapism].

Area of Science:

• Urology
• Pediatric Surgery
• Vascular Surgery

Background:

• Priapism is classified into low-flow (venous) and high-flow (arterial) types, with arterial priapism being rare and typically painless, especially in pediatric cases.
• Traumatic injuries, particularly perineal trauma, can lead to the development of arterial priapism.

Observation:

• A 5-year-old boy presented with painless arterial priapism 6 days after a closed perineal trauma.
• Imaging revealed an aneurysm and fistula of the dorsal penile artery associated with the priapism.

Findings:

• The arterial priapism, characterized by an arteriovenous fistula and aneurysm, resolved spontaneously through self-embolization 11 days after symptom onset.
• A review of 14 reported cases of childhood arterial post-traumatic priapism did not identify any instances of spontaneous resolution via self-embolization.

Implications:

• This case highlights a unique, spontaneous resolution mechanism for pediatric arterial priapism following trauma.
• The findings suggest that conservative management with close observation may be a viable initial approach in select cases of pediatric traumatic arterial priapism.
• Further research is warranted to understand the natural history and potential for spontaneous resolution in these rare injuries.