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Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
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Ruptured palmar pseudoaneurysm after carpal tunnel surgery
Stefano Tambuzzi1, Guendalina Gentile2, Lorena Ferraroli1
1Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, Milano, 20133, Italy.
Forensic Science, Medicine, and Pathology
|June 8, 2025
Summary
A rare complication following carpal tunnel surgery, a ruptured palmar pseudoaneurysm, led to a fatal hemorrhage. This case highlights a potential, though debated, link between the surgical procedure and this severe vascular event.
Area of Science:
- Forensic Pathology
- Vascular Surgery
- Anatomy
Background:
- Rupture of a superficial palmar arch pseudoaneurysm post-carpal tunnel release is exceptionally rare.
- Few cases exist in literature, with no reported fatalities.
- This study details a unique fatal case.
Purpose of the Study:
- To report a rare case of fatal hemorrhage from a palmar pseudoaneurysm.
- To investigate the potential causal link between carpal tunnel release and pseudoaneurysm rupture.
- To inform the forensic scientific community about this exceptional occurrence.
Main Methods:
- Case presentation of an elderly male patient.
- Autopsy examination to identify the source of hemorrhage.
- Histologic examination of suprafascial hematoma to confirm pseudoaneurysm rupture.
Main Results:
- The patient experienced fatal hemorrhage 22 days after carpal tunnel surgery.
- Autopsy revealed a ruptured palmar pseudoaneurysm as the sole bleeding source.
- Histology confirmed the presence of a ruptured arterial pseudoaneurysmal cavity.
Conclusions:
- The patient's death was attributed to acute hemorrhage from a ruptured palmar pseudoaneurysm.
- A potential causal link with prior surgical carpal tunnel release is suggested but requires further investigation.
- This case underscores the importance of considering rare vascular complications after hand surgery.
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