Penile Trauma in a Pediatric Patient Caused by Physical Abuse: A Case Report

Authors

  • Dahril RSUD Dr. Zainoel Abidin
  • Garbie Syahly Agung RSUD Dr. Zainoel Abidin

DOI:

https://doi.org/10.46799/jhs.v7i5.2827

Keywords:

Penile trauma, Pediatric genital injuries, Non-accidental injury, physical abuse, Reconstructive surgery

Abstract

Penile trauma in pediatric patients is a rare but clinically significant condition. While most cases result from accidental mechanisms such as falls or sports injuries, clinicians must maintain a high index of suspicion for non-accidental injury (NAI), particularly when the presenting history is inconsistent with the injury pattern or when the mechanism involves interpersonal violence. This case report aims to describe the clinical presentation, diagnostic evaluation, surgical management, and outcome of an 8-year-old boy who sustained penile trauma following suspected physical abuse. A descriptive observational design in the form of a case report was employed. Data were collected retrospectively from the patient's medical records, encompassing demographic information, clinical history, physical examination findings, imaging studies (ultrasonography with Doppler), treatment interventions, and postoperative outcomes. The patient presented with progressive penile swelling and pain. Imaging revealed intact corpora cavernosa and corpus spongiosum, with soft tissue oedema and fluid collection at the distal glans. Initial conservative management was insufficient, necessitating surgical intervention comprising debridement, penile reconstruction, and defect closure using a complex local flap technique combined with circumcision. Postoperatively, the patient demonstrated gradual wound healing with no signs of surgical site infection or early postoperative complications. The possibility of non-accidental injury should always be considered in pediatric penile trauma, particularly in cases with an inconsistent history or delayed presentation. Ultrasonography with Doppler is a valuable non-invasive imaging modality for the assessment of penile injuries. When conservative management is inadequate or presentation is delayed, timely surgical reconstruction using local flap techniques can achieve favorable functional and cosmetic outcomes while minimizing long-term morbidity.

References

Alharbi, T. A. F., Rababa, M., Alsuwayl, H., Alsubail, A., & Alenizi, W. S. (2025). Diagnostic challenges and patient safety: The critical role of accuracy—A systematic review. Journal of Multidisciplinary Healthcare, 3051–3064.

Al-Jilaihawi, S., Borg, K., Jamieson, K., Maguire, S., & Hodes, D. (2018). Clinical characteristics of children presenting with a suspicion or allegation of historic sexual abuse. Archives of Disease in Childhood, 103(6), 533–539.

Buscarini, M., Wake, R., Kolanukuduru, K. P., et al. (2024). Refining penile trauma management: Introduction of the penile trauma score. Urology, 193, 224–229.

Chung, E., Morey, A., Seyam, R., et al. (2025). Male genitalia trauma: Recommendations from the 5th International Consultation on Sexual Medicine (ICSM 2024). Sexual Medicine Reviews, 14(1), qeaf058.

Cowley, L. E., Maguire, S., Farewell, D. M., Quinn-Scoggins, H. D., Flynn, M. O., & Kemp, A. M. (2018). Factors influencing child protection professionals’ decision-making and multidisciplinary collaboration in suspected abusive head trauma cases: A qualitative study. Child Abuse & Neglect, 82, 178–191.

Dell’Atti, L. (2016). The role of ultrasonography in the diagnosis and management of penile trauma. Journal of Ultrasound, 19(3), 161–166.

Focardi, M., Gori, V., Romanelli, M., Santori, F., Bianchi, I., Rensi, R., Defraia, B., Grifoni, R., Gualco, B., & Nanni, L. (2024). “Mimics” of injuries from child abuse: Case series and review of the literature. Children, 11(9), 1103.

Franceschetti, L., Magli, F., Maggioni, L., Tambuzzi, S., Moffat, J., De Angelis, D., & Cattaneo, C. (2025). Medico-legal assessment of physical abuses in asylum cases: A multidisciplinary role for multiform issues. Forensic Science, Medicine and Pathology, 1–9.

Gómez-Bermejo, M. A., Huang, D. Y., Bertolotto, M., & Sidhu, P. S. (2023). Utility of contrast enhanced ultrasound (CEUS) in penile trauma. Insights into Imaging, 14(1), 158.

Hardesty, J., Burns, R. T., Soyster, M. E., Mellon, M., & Bernie, H. L. (2024). A review of the literature and proposed algorithm for penile fracture management. Sexual Medicine Reviews, 12(1), 100–105.

Marletta, D. A., Giuca, G., Leonetti, D., Chiodini, F., De Pellegrin, M., & Guindani, N. (2026). Fracture patterns in suspected non-accidental injury across neurodevelopmental milestones: A systematic review and evidence-informed plausibility framework. Child Abuse & Neglect, 171, 107807.

Pan, R., Liu, J., Wan, L., & Zhu, J. (2024). Case report: An extremely rare penile shrapnel injury. Frontiers in Pediatrics, 11, 1281413.

Ramanathan, S., Bertolotto, M., Freeman, S., Belfield, J., Derchi, L. E., Huang, D. Y., Lotti, F., Markiet, K., Nikolic, O., & Ramchandani, P. (2021). Imaging in scrotal trauma: A European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) position statement. European Radiology, 31(7), 4918–4928.

Setyati, R., Astuti, A., Utami, T., Adiwijaya, S., & Hasyim, D. (2024). The importance of early detection in disease management. Journal of World Future Medicine Health and Nursing, 2(1), 51–63.

Simms, A., Baradaran, N., Lue, T. F., & Breyer, B. N. (2021). Penile fractures: Evaluation and management. Urologic Clinics of North America, 48(4), 557–563.

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Published

2026-05-16