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Patients with transposition of the great arteries have good survival after surgery, but some have complications ranging from heart failure to valve dysfunction. A 42-year-old woman who underwent surgical correction in childhood, presented with aortic dissection and had a valve-sparing root operation, but died immediately postoperatively. Both aortic dissection and valve-sparing root operations in this setting have not been described before. This case highlights facts to consider in the treatment of this presentation.

a snapping sound, followed by acute pain and detumescence. 2 Most commonly caused during sexual intercourse whereby the penis slips out and strikes the hard pubic symphysis or perineal body. Other reported causes are masturbation and sudden forced flexion seen in Middle Eastern countries. Diagnosis can be made reliably on clinical grounds alone, but if the patient reports of symptoms of haematuria or urinary retention, one must suspect urethral injury, which is prevalent in 10-20% of cases 3 where a retrograde urethrogram is performed. 4 Rupture of the deep dorsal or superficial vein or suspensory ligament can mimic penile fractures. 4 Magnetic resonance imaging, cavernosography and ultrasonography are useful investigations in doubtful diagnosis. Early surgery has shown to lead to early discharge and success rates of approximately 90% where patients can subsequently attain normal erections. 3 References 1. Miller S, McAninch JW. Penile fractures and soft tissue injury. In: McAninch JW (ed.).

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