Idiopathic true ulnar artery aneurysm

INTRODUCTION AND IMPORTANCE: True ulnar artery aneurysms are a rare entity, with existing literature suggesting that most of these aneurysms are due to trauma. This case report sheds light on a true ulnar artery aneurysm that was deemed to be idiopathic. CASE PRESENTATION: A 49-year-old lady presented with numbness in the medial 3 fingers of the left hand, tenderness over the medial forearm, and a palpable ulnar artery pulse. There was no history of trauma. An arterial ultrasound, MRI of the forearm, and upper limb angiography confirmed the diagnosis of ulnar artery aneurysm. Surgical repair of the aneurysm was done with excellent immediate post-operative and follow up results. CLINICAL DISCUSSION: Trauma is the most common cause for the development of ulnar artery aneurysms. In this case however, after detailed history taking, physical examination, and thorough investigations, the cause of the patient’s aneurysm was deemed to be idiopathic. Treatment of ulnar aneurysms are not well established due to the rarity of the disease. A surgical approach however may be considered depending on the location of the aneurysm along with the patient’s symptoms. CONCLUSION: A high index of suspicion, thorough history, physical examination, and appropriate investigations are required to diagnose ulnar artery aneurysms. Surgical intervention is indicated to relieve symptoms of nerve compression and prevent limb threatening ischemia. Regular post-operative follow up is essential to detect potential graft dysfunction and to ensure a good outcome.