Fig. 8

Penile haematoma with pseudoaneurysm. A 38-year-old man presented to the emergency department following a pedal bicycle accident with blunt trauma to the non-erect penis, with clinical high-flow priapism at presentation. Ultrasound was performed. In a sagittal plane in B mode (a) where an ill-defined area of mixed echogenicity (between arrowheads) in the right corpus cavernosum at the base of the penis, suspicious of haematoma is seen. The colour Doppler US (b) shows a deformity of a branch of the cavernosal artery (arrow) with turbulent flow in its interior, consistent with pseudoaneurysm. CEUS (c) confirms the presence of the non-enhancing haematoma (between arrowheads) and the pseudoaneurysm, which enhances avidly (thin arrow) in the arterial phase. A complementary MRI was performed (sagittal T1 pre-contrast (d), sagittal T1 FSE C+ (e)), showing an area of hyperenhancement of the right corpus cavernosum (arrowhead), compatible with the known haematoma. Within the haematoma, there is a hyperenhancing saccular area corresponding to the pseudoaneurysm (arrow). Note the higher spatial resolution of US compared to MRI in assessing the penis