Axilloaxillary Arteriovenous Fistula Caused by Previous Penetrating Trauma

Traumatic axilloaxillary arteriovenous (AV) fistulas are rare occurrences, with the predominance of AV fistulas in this region occurring as an alternative surgical intervention in patients who are undergoing hemodialysis.

We describe the case of a young man with this condition caused by a previous penetrating trauma who had a delayed diagnosis primarily because of the infrequency of the clinical presentation. This is one of a few documented cases of axilloaxillary AV fistulas in the setting of trauma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Axilloaxillary AV fistulas present with loud machinery like cardiac murmurs that can be similar to patients with coarctation of the aorta and patent ductus arteriosus; however, important clinical examination features can help distinguish the two conditions. Diagnosis is important in avoiding late-stage complications and more technically difficult surgical repairs.