Open AccessPseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging
Author(s) -
Andrea Benedetto Galosi,
C. Capretti,
Luca Leone,
Marco Tiroli,
Daniele Cantoro,
Massimo Polito
Publication year - 2016
Publication title -
archivio italiano di urologia andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.429
H-Index - 23
eISSN - 2282-4197
pISSN - 1124-3562
DOI - 10.4081/aiua.2016.4.317
Subject(s) - medicine , pseudoaneurysm , arteriovenous fistula , radiology , embolization , surgery , aneurysm
Pseudoaneurysm (PA) associated with an arteriovenous fistula (AVF) of the internal pudendal artery branches are very uncommon. We report a case of post-traumatic PA with AVF connected to Santorini plexus. Diagnosis was made with trans-rectal ultrasound (TRUS) after recurrent hematuria. TRUS reported a 1.7 × 1.4 × 1.5 cm anechoic area, on anterior prostate apex close to Santorini plexus. The use of color Doppler in this area revealed high flow velocity that was indicative for AVF. The feeding artery was a distal branch of the left pudenda artery. After selective embolization was observed complete occlusion of the feeding branches and disappearance of PA with AVF. Prostate PA with concomitant symptomatic AVF detected with TRUS has not yet described in literature after pelvic trauma and represents complex diagnostic challenges. This case report suggests that the use of TURS and color Doppler can provide an important diagnostic and follow-up to address the clinical suspicion of occult vascular injuries using a noninvasive approach.