Ruptured pseudoaneurysm of the radial artery

A 40-year-old man presented with a progressively increasing swelling over the ventral aspect of the right wrist of 23 days duration following a laceration. The swelling was soft, pulsatile and was intermittently bleeding, with poor distal capillary filling and cold distal extremity. Clinically it was diagnosed as pseudoaneurysm of the radial artery and was sent for a duplex scan for confirmation. The lesion ruptured in the radiology department before the scan was done, and the patient went into hypovolaemia. In view of this, the patient underwent exploration of the pseudoaneurysm under brachial block, and the radial artery was found to be transected just proximal to the dorsal branch. It was decided to repair the artery as there was no evidence of adequate circulation supply or the patency of the ulnar artery preoperatively. Doppler study at 15 and 45 days postoperatively showed good flow through, with no evidence of thrombus.