A Small Cut, a Big Consequence: A Case Report of a Radial Artery Pseudoaneurysm

Radial artery pseudoaneurysm is an uncommon complication of penetrating wrist trauma, more frequently associated with iatrogenic procedures than with trivial lacerations. While radial artery injuries from penetrating trauma can present as isolated vessel damage, they frequently involve complex injuries affecting adjacent structures, such as veins, tendons, and nerves. This case report highlights a rare instance of an isolated radial artery pseudoaneurysm resulting from a minor laceration, emphasizing the need for heightened clinical suspicion, even in seemingly innocuous injuries. We report the case of a middle-aged male who sustained a knife-induced volar wrist laceration less than 1 cm in length. Computer tomography (CT) angiography at presentation excluded major vascular injury, and the wound was sutured. Ten days later, the patient returned with a pulsatile swelling at the wound site. Doppler ultrasonography confirmed a radial artery pseudoaneurysm with partial thrombus formation. The patient underwent vascular surgical repair, with a good outcome. This case highlights the importance of thorough vascular assessment in apparently minor wrist injuries. Incorporating bedside ultrasonography in the emergency department (ED) may support earlier recognition of vascular complications.