ABSTRACT
El priapismo arterial es una rara patología en pacientes pediátricos, originada por una fístula entre la arteria cavernosa y los sinusoides del cuerpo cavernoso, habitualmente secundaria a un traumatismo perineal. Presentamos el caso de un varón de 16 años con priapismo arterial de 5 días de evolución tras una caída a horcajadas, tratado satisfactoriamente mediante embolización arterial supraselectiva con material reabsorbible. Seis meses después, el paciente presenta detumescencia completa sin disfunción eréctil asociada. La embolización arterial en pacientes pediátricos es compleja debido al menor calibre arterial y la necesidad de control de la arteria pudenda interna contralateral para evitar el desarrollo de complicaciones. La utilización de material reabsorbible permite disminuir el riesgo de disfunción eréctil posterior y, aunque presenta un mayor índice de recurrencias, constituye una alternativa eficaz en el tratamiento de esta patología.(AU)
Arterial priapism is a rare condition in pediatric patients, caused by a fistula between the cavernous artery and the sinusoids of the corpus cavernosum, usually secondary to perineal trauma. We report the case of a 16 year old child with arterial priapism of 5 days duration following a fall astride, successfully treated by superselective arterial embolization with absorbable material. Six months later the patient had complete detumescence without secondary erectile dysfunction. Arterial embolization in pediatric patients is complex due to the smaller arterial size and the need to control the contralateral internal pudendal artery to prevent the development of complications. The use of absorbable material helps reduce the risk of subsequent erectile dysfunction and, although it has a higher rate of recurrence, is an alternative for the treatment of this pathology.(AU)
ABSTRACT
El priapismo arterial es una rara patología en pacientes pediátricos, originada por una fístula entre la arteria cavernosa y los sinusoides del cuerpo cavernoso, habitualmente secundaria a un traumatismo perineal. Presentamos el caso de un varón de 16 años con priapismo arterial de 5 días de evolución tras una caída a horcajadas, tratado satisfactoriamente mediante embolización arterial supraselectiva con material reabsorbible. Seis meses después, el paciente presenta detumescencia completa sin disfunción eréctil asociada. La embolización arterial en pacientes pediátricos es compleja debido al menor calibre arterial y la necesidad de control de la arteria pudenda interna contralateral para evitar el desarrollo de complicaciones. La utilización de material reabsorbible permite disminuir el riesgo de disfunción eréctil posterior y, aunque presenta un mayor índice de recurrencias, constituye una alternativa eficaz en el tratamiento de esta patología.
Arterial priapism is a rare condition in pediatric patients, caused by a fistula between the cavernous artery and the sinusoids of the corpus cavernosum, usually secondary to perineal trauma. We report the case of a 16 year old child with arterial priapism of 5 days duration following a fall astride, successfully treated by superselective arterial embolization with absorbable material. Six months later the patient had complete detumescence without secondary erectile dysfunction. Arterial embolization in pediatric patients is complex due to the smaller arterial size and the need to control the contralateral internal pudendal artery to prevent the development of complications. The use of absorbable material helps reduce the risk of subsequent erectile dysfunction and, although it has a higher rate of recurrence, is an alternative for the treatment of this pathology.
Subject(s)
Humans , Male , Adolescent , Priapism/etiology , Priapism/physiopathology , Priapism/therapy , Regional Blood Flow , Wounds, Nonpenetrating/complications , Embolization, Therapeutic/methods , Scrotum/injuriesABSTRACT
Arterial priapism is a rare condition in pediatric patients, caused by a fistula between the cavernous artery and the sinusoids of the corpus cavernosum, usually secondary to perineal trauma. We report the case of a 16 year old child with arterial priapism of 5 days duration following a fall astride, successfully treated by superselective arterial embolization with absorbable material. Six months later the patient had complete detumescence without secondary erectile dysfunction. Arterial embolization in pediatric patients is complex due to the smaller arterial size and the need to control the contralateral internal pudendal artery to prevent the development of complications. The use of absorbable material helps reduce the risk of subsequent erectile dysfunction and, although it has a higher rate of recurrence, is an alternative for the treatment of this pathology.
Subject(s)
Embolization, Therapeutic/methods , Priapism/etiology , Priapism/therapy , Scrotum/injuries , Wounds, Nonpenetrating/complications , Adolescent , Decision Trees , Humans , Male , Priapism/physiopathology , Regional Blood FlowABSTRACT
METHOD: Beyond postoperative suspicion, retrograde pyelogram was performed, the images of which are displayed, and demonstrated the fistula. RESULTS: Treatment has been definitive nephrectomy after failed attempt to seal the fistula with suture and TachoSil. CONCLUSIONS: Although radiofrequency ablation can be a valid technique for treating small renal tumors in patients with high morbidity, it is not without significant complications as described in this case, despite the precautions taken.
Subject(s)
Carcinoma, Renal Cell/surgery , Catheter Ablation/adverse effects , Colonic Diseases/etiology , Intestinal Fistula/etiology , Kidney Diseases/etiology , Kidney Neoplasms/surgery , Urinary Fistula/etiology , Humans , MaleABSTRACT
OBJETIVO: Describir un caso clínico de fístula reno cólica como complicación de ablación por radiofrecuencia de carcinoma de células renales. Se revisa la literatura y se exponen las diferentes actitudes diagnósticas y terapéuticas. MÉTODO: Tras la sospecha postoperatoria se realizó pielografía retrograda, cuyas imágenes se muestran, que demuestra la fístula. RESULTADO: El tratamiento definitivo ha sido la nefrectomía tras intento fallido de sellar la fístula con sutura y tachosil. CONCLUSIÓNES: Si bien la ablación por radiofrecuencia puede ser una técnica válida para el tratamiento del tumores renales de pequeño tamaño en pacientes con elevada morbilidad, no está exenta de complicaciones importantes como la descrita en este caso, a pesar de las precauciones tomadas(AU)
OBJECTIVES: To describe a clinical case of renocolic fistula as a complication of radiofrequency ablation of renal cell carcinoma. We reviewed the literature and presented different diagnostic and therapeutic approaches. METHOD: Beyond postoperative suspicion, retrograde pyelogram was performed, the images of which are displayed, and demonstrated the fistula. RESULTS: Treatment has been definitive nephrectomy after failed attempt to seal the fistula with suture and TachoSil. CONCLUSIONS: Although radiofrequency ablation can be a valid technique for treating small renal tumors in patients with high morbidity, it is not without significant complications as described in this case, despite the precautions taken(AU)
