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Pseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging

Andrea B. Galosi, Camilla Capretti, Luca Leone, Marco Tiroli, Daniele Cantoro, Massimo Polito
  • Andrea B. Galosi
    Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona, Italy | galosiab@yahoo.it
  • Camilla Capretti
    Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona, Italy
  • Luca Leone
    Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona, Italy
  • Marco Tiroli
    Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona, Italy
  • Daniele Cantoro
    Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona, Italy
  • Massimo Polito
    Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona, Italy

Abstract

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.

Keywords

Prostate; Pseudoaneurysm; Arteriovenous fistula; Transrectal ultrasonography; Pelvic trauma

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Submitted: 2017-01-10 14:11:47
Published: 2016-12-30 00:00:00
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Copyright (c) 2017 Andrea B. Galosi, Camilla Capretti, Luca Leone, Marco Tiroli, Daniele Cantoro, Massimo Polito

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