title: Atypical presentation of priapism in a patient with acute iliocaval deep venous thrombosis secondary to May-Thurner syndrome.
abstract: We report on a 42-year-old male who presented with priapism, severe scrotal swelling, and left lower extremity pain and swelling. Initial management of priapism failed, and he was noted to have both cavernosal and glandular venous obstruction. Computed tomography (CT) was performed and identified extensive acute thrombosis involving the distal inferior vena cava and the left iliac veins. Pharmacomechanical thrombolysis (PMT) was started over the course of two days. At completion of thrombolysis, the culprit lesion in the left common iliac vein was treated with angioplasty and stenting. His postoperative course was uneventful, and his priapism as well as the scrotal and leg swelling improved. He was discharged home on full anticoagulation. To our knowledge, this is the first available description of this rare presentation along with a literature review of the underlying vascular etiology for priapism.
authors.affiliation: Department of Vascular Surgery, Charleston Area Medical Center, West Virginia University, Charleston, WV, USA. saadieras@yahoo.com
authors.forename: Saadi
authors.initials: S
authors.lastname: Alhalbouni
authors.forename: Samuel
authors.initials: S
authors.lastname: Deem
authors.forename: Shadi
authors.initials: S
authors.lastname: Abu-Halimah
authors.forename: Betro T
authors.initials: BT
authors.lastname: Sadek
authors.forename: Albeir
authors.initials: A
authors.lastname: Mousa
mesh_terms: D000208:Acute Disease; D000328:Adult; D017130:Angioplasty / Q000295:instrumentation; D000925:Anticoagulants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging; D008297:Male; D062108:May-Thurner Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010690:Phlebography / Q000379:methods; D011317:Priapism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D015607:Stents; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
chemical_list: D000925:Anticoagulants
keywords: DVT; IVC; iliac; priapism; thrombosis