Post-traumatic arterial priapism in the child: A study of four cases

The authors report four cases of arterial priapism in the child, a rare con dition since only 13 cases are described in the literature. High-flow priap ism follows perineal or penile injury with damage to a cavernosal artery an d formation of an arterio-sinusoidal fistula. The onset may be immediate bu t more often occurs after a few days. Arterial priapism is painless, as the corpora cavernosa are less tumescent in the anterior third of the penis. T he clinical appearance and circumstances of onset suggest the diagnosis. Do ppler ultrasound is the complementary investigation of choice, confirming a nd localising the fistula. Various methods of treatment have been proposed. Injections of alphastimulant seem ineffective in most cases and are not wi thout danger. Surgery, which is potentially damaging, has been used only in the adult. Most authors propose embolising with resorbable material the ar tery which feeds the fistula. However, priapism may resolve spontaneously i n less than three weeks, as occurred in our cases, without recurrence or su bsequent erectile dysfunction. We thus consider the condition may initially be managed by observation alone, with recourse to embolisation if priapism does not resolve after a period of time which however remains to be define d.