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Published on: August 11, 2015
Diagnosis and Management of a 4-Year-Old Male with Ulnar Artery Pseudoaneurysm
Nicolas Artz1, Harel Scwartzberg1, Aran Yoo1
1Department of Orthopaedic Surgery, Louisiana State University Health Science Center, New Orleans, Louisiana.
Insights
Pediatric pseudoaneurysms, rare vascular injuries, can lead to complications if misdiagnosed. This case highlights successful surgical reconstruction of a pediatric ulnar artery pseudoaneurysm using an arterial graft.
Area of Science:
- Vascular Surgery
- Pediatric Surgery
- Radiology
Background:
- Pseudoaneurysms result from intimal tears causing hemorrhage.
- Upper extremity pseudoaneurysms are common in adults due to trauma.
- Pediatric pseudoaneurysms are rare and often misdiagnosed, risking complications.
Observation:
- A 4-year-old male presented with a right ulnar artery pseudoaneurysm.
- Diagnosis was confirmed via ultrasound and CT angiography.
- Surgical resection and arterial graft reconstruction were performed.
Findings:
- The ulnar artery was reconstructed using a graft from the lateral circumflex femoral artery.
- Arterial patency was confirmed by strip and Allen's tests.
- Successful reconstruction of the pediatric pseudoaneurysm was achieved.
Implications:
- Highlights the importance of timely diagnosis and management of pediatric pseudoaneurysms.
- Advocates for arterial reconstruction in pediatric cases, irrespective of collateral flow.
- Provides insights into surgical techniques for rare pediatric vascular injuries.
Background:
Pseudoaneurysms are a rare vascular phenomenon caused by an intimal tear leading to hemorrhaging into surrounding tissue. Upper extremity pseudoaneurysms are well documented in adult patients and are attributed to repetitive trauma. Pediatric pseudoaneurysms are rare and are frequently misdiagnosed, which could lead to serious complications.
Methods:
This report presents the case of a 4-year-old male patient with an ulnar pseudoaneurysm of the right upper extremity. The pseudoaneurysm was diagnosed by ultrasound and computed tomography angiography and subsequently resected. The ulnar artery was reconstructed with an arterial graft using the descending branch of the lateral circumflex femoral artery. Patency of the end-to-end anastomosis was confirmed by strip testing and Allen's test.
Conclusions:
The aim of this report is to provide a background of upper extremity pseudoaneurysms and describe their rare occurrence in pediatric patients and potential for complications upon misdiagnosis. Additionally, this report aims to highlight an alternative approach to management of pediatric pseudoaneurysms and advocate for reconstruction of the affected artery regardless of collateral flow being established.
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