Diagnosis of Mondor’s Disease in the Emergency Department with Bedside Ultrasound

Abstract

Mondor's disease is a rare condition characterized by a superficial thrombophlebitis that can occur in the thoracoabdominal and genital areas. Findings with ultrasound in penile Mondor's disease are readily measurable: a noncompressible penile vein without flow and absence of tears of the corpus cavernosum or tunica albuginea, hematoma, or evidence of fracture of the penis. We present a case of Mondor's disease, diagnosed with bedside ultrasound, in the emergency department. Ultrasonography is readily available within the emergency department, and we suggest its use in aiding diagnosis of genitourinary disorders such as Mondor's disease.

Traumatic Penile Pain: A Case of Dorsal Vein Thrombophlebitis after Intercourse

“…Mondor's disease is named after Henri Mondor who first reported superficial thrombophlebitis in 1939 [ 1 ]. Incidence is very rare as there is a very limited number of published literature regarding Penile Mondor's disease.…”

“…Ages range from 18 to 70 and symptoms can be immediate or delayed up to 48 hrs after inciting incident [ 3 ]. It can be painful although most literature reports painless cord-like band on dorsal aspect of penis, overlying skin intact, mobile without evidence of infection or inflammation [ 1 , 4 ]. Differential Diagnoses that must be entertained include penile fracture, Peyronie's disease, and sclerotizing lymphangitis.…”

“…Mainstay of treatment includes symptomatic or supportive care until symptoms resolve spontaneously. These measures include pelvic/phallic rest and NSAIDs [ 1 – 5 ]. One particular study of 30 patients by Özkan et al details a treatment of cefuroxime 500 mg twice daily for one week, aspirin 300 mg daily, and topical heparinoid ointment twice daily for a month.…”

“…In this study 93% of patients had a normal physical exam at one month [ 6 ]. Most symptoms resolve spontaneously within 1–6 weeks and very few references recommend follow-up for a hypercoagulable workup or evaluation [ 1 ].…”

Mondor’s disease after aesthetic breast surgery: A case series and literature review

“…Nonsteroidal anti-inflammatory drugs, anticoagulation therapy, and even surgery have been used for its treatment as necessary. [ 3 7 ] Successful triamcinolone injections have been reported recently. [ 8 ]…”