Scrotal hematoma following femoral artery puncture #FirstOfI
The present case has been reported in the Journal of Clinical Case Reports.

A 65‐year‐old man with chronic renal failure underwent emergent coronary angiography, because of chest pain. The authors inserted a 5‐Fr long sheath into right femoral artery under fluoroscopy. As there was no significant coronary stenosis, they removed the femoral sheath and performed manual compression for 20 minutes.

His scrotum rapidly grew accompanying severe scrotum pain. Contrast‐enhanced computed tomography (CT) revealed an extravasation of contrast media in the inguinal canal from the right femoral artery.

Following additional 30 minutes’ manual compression, the extravasation resolved. The authors speculated that they might puncture the femoral artery from the medial side to the lateral side. Thus, tey punctured both the femoral artery and the inguinal canal together. The direct connection between the femoral artery and the inguinal canal occurred.

Key clinical message:-
- The scrotal hematoma can happen following testicular torsion, adrenal hemorrhage, or birth trauma.

- This was the first report regarding scrotal hematoma following puncture of the femoral artery.

- The present case indicates the importance of quick observation of the scrotum, when the puncture of femoral artery was performed.