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

M L Martínez del Castillo1, C Miguélez Lago, M García Mérida

  • 1Hospital Materno-Infantil, Complejo Hospitalario Carlos Haya, Málaga.

Actas Urologicas Espanolas
|February 24, 2001
PubMed
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Arterial priapism, a rare condition in children, can result from trauma. This case report details a 5-year-old boy whose painless arterial priapism resolved spontaneously via self-embolization, a unique outcome not previously documented.

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.

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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.