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Pseudoaneurysm formation following a traumatic wrist laceration

Published online by Cambridge University Press:  11 May 2015

Naveen Poonai ,
Rodrick Lim  and
Tim Lynch
Naveen Poonai*
Affiliation:
Department of Paediatrics, University of Western Ontario, London Health Sciences Centre, Children's Hospital of Western Ontario, London, ON
Rodrick Lim
Affiliation:
Department of Paediatrics, University of Western Ontario, London Health Sciences Centre, Children's Hospital of Western Ontario, London, ON
Tim Lynch
Affiliation:
Department of Paediatrics, University of Western Ontario, London Health Sciences Centre, Children's Hospital of Western Ontario, London, ON
*
London Health Sciences Centre, Victoria Hospital, Room E1-110, 800 Commissioners Road East, London, ON N6A 2V5; [email protected]

Abstract

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Pseudoaneurysms occur secondary to partial disruption of the arterial wall. They are a commonly described complication of arterial injury, with penetrating injury and iatrogenic arterial catheterization being the most common etiologies in children. Many present weeks to months after the injury, and the initial vascular injury is often missed. The complications of pseudoaneurysm, which include thromboembolism, neurapraxia, and compartment syndrome, underscore the importance of early recognition and management. Definitive therapy consists of ultrasound-guided compression or resection and possible graft interposition. We describe a case of pseudoaneurysm formation in the radial artery of an adolescent girl 6weeks following a penetrating injury. The patient’s injury was complicated by sensory and motor deficits consistent with ulnar nerve compression. This case attests to the importance of adequately ruling out arterial injury in penetrating injury and close followup if the history is suggestive. In addition, a high index of suspicion is warranted to facilitate imaging of a pulsatile mass to avoid confusion of a thrombosed artery with an abscess.

Keywords

pseudoaneurysmradial artery
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 13 , Issue 1 , January 2011 , pp. 48 - 52
Copyright
Copyright © Canadian Association of Emergency Physicians 2011

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