Traumatic pseudo-aneurysm in a 5-year-old child, case report and literature review

Pseudo-aneurysm can be formed by iatrogenic factors, as well as non-iatrogenic factors. In the pediatric population, there have only been a few recorded incidences. The work has been reported in line with the SCARE criteria.

In our case, a five-year-old male who was medically free presented with a complaint of left foot swelling after a one-month history of glass trauma and two episodes of bleeding. Upon presentation to our facility, an examination of the left foot's dorsum revealed a 2.0 ∗ 2.0 cm pulsatile non-tender swelling with no symptoms of infection, and a healed scar. A lower limb arterial doppler ultrasonography was performed, and it revealed a 1 cm partially thrombosed pseudoaneurysm protruding from the Dorsalis Pedis Artery (DPA).

Lower extremity peripheral aneurysms, whether true aneurysm or a pseudo-aneurysm, are uncommon in adults and usually occur in the popliteal artery (70 %), femoral artery (20 %), and only (10 %) of aneurysms present in other locations (Dahman et al., 2021). This Condition is even extremely unusual in pediatric population, where only a few cases have been reported. Doppler ultrasonography was used as a radiological examination and a diagnostic approach in the case of our patient. Due to the rarity of this illness, there are no clear guidelines for approaching patients with similar symptoms.

A dorsalis pedis pseudoaneurysm should be considered in any traumatic injury that has resulted in a hematoma in the dorsum of the foot that is not healing. In our case, a primary aneurysm excision with DPA ligation appears to be a safe procedure with no effect on foot perfusion or function.