title: Pseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging.
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.
authors.affiliation: Institute of Urology, Department of Specialized Clinical Sciences and Odontostomatology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria, Ancona. galosiab@yahoo.it.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Galosi
authors.forename: Camilla
authors.initials: C
authors.lastname: Capretti
authors.forename: Luca
authors.initials: L
authors.lastname: Leone
authors.forename: Marco
authors.initials: M
authors.lastname: Tiroli
authors.forename: Daniele
authors.initials: D
authors.lastname: Cantoro
authors.forename: Massimo
authors.initials: M
authors.lastname: Polito
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000209:etiology; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D010388:Pelvis / Q000000981:diagnostic imaging / Q000293:injuries*; D011467:Prostate / Q000098:blood supply / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging*