Cargando…

Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report

Ulnar artery pseudoaneurysm (UAP) is a rare occurrence after penetrating injury to the distal upper extremity and may lead to complications such as rupture, sensorimotor dysfunction, and compartment syndrome. We present the case of a 57-year-old man who developed delayed UAP after suffering a penetr...

Descripción completa

Detalles Bibliográficos
Autores principales: Martins, Russell Seth, Gill, Ali Abdullah, Maqbool, Baila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529021/
https://www.ncbi.nlm.nih.gov/pubmed/36211095
http://dx.doi.org/10.7759/cureus.28744
_version_ 1784801414290079744
author Martins, Russell Seth
Gill, Ali Abdullah
Maqbool, Baila
author_facet Martins, Russell Seth
Gill, Ali Abdullah
Maqbool, Baila
author_sort Martins, Russell Seth
collection PubMed
description Ulnar artery pseudoaneurysm (UAP) is a rare occurrence after penetrating injury to the distal upper extremity and may lead to complications such as rupture, sensorimotor dysfunction, and compartment syndrome. We present the case of a 57-year-old man who developed delayed UAP after suffering a penetrating injury to the right forearm. UAP was diagnosed a week after the injury using CT angiography (CTA), which was indicated due to the onset of ulnar nerve palsy (mildly reduced hand-grip strength and fourth- and fifth-digit hypoesthesia and numbness) and growing swelling and tenderness of the right forearm. Due to concerns about UAP and hematoma formation, with resultant compression of the ulnar nerve and suspected hematoma infection, surgical intervention was performed wherein a moderate-size hematoma was evacuated and the ulnar artery was ligated. The decision to ligate rather than reconstruct was based on the suspected infected nature of the hematoma and adequate perfusion of the palmar arch by the radial artery. This case highlights the need for maintaining a strong index of suspicion for UAP after penetrating trauma to the distal upper extremity, due to the possibility of debilitating nerve deficits and compartment syndrome complicating late diagnosis. We also present an algorithm for the choice of management modality for UAP, which is a valuable addition to the existing literature.
format Online
Article
Text
id pubmed-9529021
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-95290212022-10-06 Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report Martins, Russell Seth Gill, Ali Abdullah Maqbool, Baila Cureus Trauma Ulnar artery pseudoaneurysm (UAP) is a rare occurrence after penetrating injury to the distal upper extremity and may lead to complications such as rupture, sensorimotor dysfunction, and compartment syndrome. We present the case of a 57-year-old man who developed delayed UAP after suffering a penetrating injury to the right forearm. UAP was diagnosed a week after the injury using CT angiography (CTA), which was indicated due to the onset of ulnar nerve palsy (mildly reduced hand-grip strength and fourth- and fifth-digit hypoesthesia and numbness) and growing swelling and tenderness of the right forearm. Due to concerns about UAP and hematoma formation, with resultant compression of the ulnar nerve and suspected hematoma infection, surgical intervention was performed wherein a moderate-size hematoma was evacuated and the ulnar artery was ligated. The decision to ligate rather than reconstruct was based on the suspected infected nature of the hematoma and adequate perfusion of the palmar arch by the radial artery. This case highlights the need for maintaining a strong index of suspicion for UAP after penetrating trauma to the distal upper extremity, due to the possibility of debilitating nerve deficits and compartment syndrome complicating late diagnosis. We also present an algorithm for the choice of management modality for UAP, which is a valuable addition to the existing literature. Cureus 2022-09-03 /pmc/articles/PMC9529021/ /pubmed/36211095 http://dx.doi.org/10.7759/cureus.28744 Text en Copyright © 2022, Martins et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Trauma
Martins, Russell Seth
Gill, Ali Abdullah
Maqbool, Baila
Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
title Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
title_full Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
title_fullStr Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
title_full_unstemmed Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
title_short Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
title_sort delayed formation of traumatic ulnar artery pseudoaneurysm presenting with ulnar nerve palsy: a case report
topic Trauma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529021/
https://www.ncbi.nlm.nih.gov/pubmed/36211095
http://dx.doi.org/10.7759/cureus.28744
work_keys_str_mv AT martinsrussellseth delayedformationoftraumaticulnararterypseudoaneurysmpresentingwithulnarnervepalsyacasereport
AT gillaliabdullah delayedformationoftraumaticulnararterypseudoaneurysmpresentingwithulnarnervepalsyacasereport
AT maqboolbaila delayedformationoftraumaticulnararterypseudoaneurysmpresentingwithulnarnervepalsyacasereport