Fig. 5

Penile fracture. Haematoma with active bleeding. A 43-year-old man presented with blunt trauma to the penis during sexual intercourse. B-mode US (a) demonstrated an area of interruption of the tunica albuginea (between arrowheads) of the left corpus cavernosum with a focal outpouching with mixed echogenicity (asterisk *) extending from the point of rupture. There is a low reflectivity round structure at the site of rupture (arrow). A CEUS was performed (b), confirming with more precision the site of the rupture of the tunica albuginea (between arrowheads). The focal outpouching that does not enhance corresponds to a haematoma. The low-reflectivity area seen in B-mode (arrow) corresponds to active extravasation spreading from the site of rupture of the tunica. CEUS allows the detection of the precise location of the rupture, the differentiation of a haematoma from herniated cavernosa parenchyma and the diagnosis of a coexistent active contrast extravasation (arrow). The site of rupture was marked over the skin, allowing for a conservative surgical approach