Clinical Practice and Cases in Emergency Medicine

Introduction: Partial segmental thrombosis of the corpus cavernosum is a rare vascular condition that may present with nonspecific groin or pelvic pain and mimic more common surgical or urologic emergencies.

Case Report: A 33-year-old man presented to the emergency department with acute left-sided groin and pelvic pain after straining during defecation. Initial history and evaluation raised concern for incarcerated inguinal hernia, epididymo-orchitis, renal colic, lymphadenopathy, and soft tissue infection. Computed tomography demonstrated asymmetric enlargement of the left corpus cavernosum, while penile ultrasound showed diminished cavernosal flow. Magnetic resonance imaging confirmed segmental thrombosis of the left corpus cavernosum. The patient was treated conservatively with rivaroxaban and analgesia, resulting in symptomatic improvement.

Conclusion: Partial segmental thrombosis of the corpus cavernosum should be considered in patients presenting with unexplained groin or perineal pain when standard abdominal, penile, testicular, and hernia evaluations are unrevealing. Magnetic resonance imaging may be necessary for definitive diagnosis, and conservative management is frequently successful.