EM Forum Case #105
"The Eggplant Deformity"
by Charlene Babcock Irvin, MD, FACEP
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A 38 y/o male presents with pain in his penis. He reports having sex the night
before, and is suddenly experiencing severe pain. He noticed his penis swelled
immediately. He thought it might get better overnight, so he waited until
morning to come to the ED. He is able to void, and he doesn’t note any blood in
his urine.
PMH: No previous surgeries, no medical problems.
SH: Occasional smoker, recreational drinker, no drugs.
Medications: Ibuprofen last night without significant relief.
PE: 158/80, RR=20, P=90, Afebrile.
HEENT, Heart, Lungs, Abd all normal.
Penis with eggplant deformity. Considerable swelling to the entire shaft of the
penis, and curvature to the left was noted. The scrotum was also swollen, but no
testicle swelling was appreciated. Testicles were both descended and normal by
palpation. There was no external bleeding, and no blood at the meatus.
Questions:
1. What is the diagnosis?
2. What is the treatment?
3. In addition to a call to urology, what else do you need to do?
4. How do you perform a penile aspiration/injection in sickle cell patients with
Priapism?
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