Transperineal sonography of a large vulvar hematoma following blunt perineal trauma

Vulvar hematomas may result from puerperal or nonpuerperal-related trauma. These perineal injuries, especially the puerperal type, may be life-threatening and require surgical exploration, evacuation, and hemostasis. In the absence of acute hematoma expansion, expectant management may suffice. Experience with transperineal sonography in the assessment of female perineal trauma has been limited to a single case report pertaining to a puerperal vulvar hematoma. We present an unusual case in which the transperineal sonographic appearance of a large vulvar hematoma following a straddle injury to the perineum assisted in the expectant management of this condition.