Fragment wound pseudoaneurysm presenting 54 years after injury(1)

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Medical Case Reports

Background:

• Delayed complications from combat-related injuries can manifest decades later.
• Traumatic pseudoaneurysms, particularly those from historical combat wounds, pose unique diagnostic and management challenges.
• Acute arterial insufficiency requires prompt diagnosis and intervention to preserve limb viability.

Purpose of the Study:

• To report the longest documented delayed presentation of a traumatic pseudoaneurysm.
• To emphasize the critical need for thorough vascular assessment in patients with a history of combat trauma.
• To compare the challenges of managing combat-associated injuries versus civilian vascular trauma.

Main Methods:

• Case presentation of a 74-year-old male with acute left leg ischemia.
• Diagnostic workup including physical examination and arteriography.
• Surgical intervention involving embolectomy and pseudoaneurysm repair using saphenous vein graft.

Main Results:

• Identification of a superficial femoral artery (SFA) pseudoaneurysm with associated mortar fragments and distal obstruction.
• Successful revascularization of the ischemic limb.
• Resolution of acute arterial insufficiency and limb threat.

Conclusions:

• This case represents the longest reported delayed presentation of a traumatic false aneurysm.
• Proper assessment of underlying potential vascular injury is crucial to avoid delayed complications.
• Combat-associated injuries present unique challenges compared to civilian vascular trauma.