After fracture of the penis (injury to the tunica albuginea) with intact Buck’s fascia, there occurs hematoma: (AIIMS May 2012)
|A||The penis and scrotum|
|B||At the perineum in a butterfly shape|
|C||Penis, scrotum, perineum and lower part of anterior abdominal wall|
|D||Shaft of the penis only|
a. Diagnosis of albugineal rupture is usually made from a characteristic history of severe pain with a cracking or popping sound during acute bending of the erect penis, followed by immediate detumescence, penile swelling, and deformity.
b. Albugineal rupture is associated with urethral injury in 10–20% of cases.
c. Penile hematoma is confined to the shaft when the Buck’s fascia is intact; otherwise, it is contained only by the Colles’ fascia, resulting in scrotal and perineal ecchymosis with a characteristic butterfly pattern.
d. Sonography can detect the exact site of the tear as an interruption of the thin echogenic line of the tunica albuginea and show evidence of associated hematoma.
e. In the absence of external penetrating traumas, an indirect sign of urethral injury is the presence of air in the cavernosal bodies If the Buck fascia is intact, penile ecchymosis is confined to the penile shaft.
f. If the Buck fascia has been violated, the swelling and ecchymosis are contained within the Colles fascia.
g. In this instance, a "butterfly-pattern" ecchymosis may be observed over the perineum, scrotum, and lower abdominal wall.