Pediatric Digital Artery Pseudoaneurysm From Repetitive Compression While Gripping Toys

Pseudoaneurysm of the finger is a rare condition, commonly caused by penetrating injury. However, repetitive blunt trauma can also lead to vascular injury, particularly in individuals exposed to chronic minor compression, such as industrial workers and athletes. Accurate diagnosis and appropriate surgical planning are essential, as pseudoaneurysms may cause distal ischemia or digital nerve dysfunction if left untreated. We report a rare case of a 4-year-old boy with a pulsatile mass on his right middle finger, without any history of overt trauma. He had a habit of holding hard toys between his fingers and sometimes slept while gripping them, suggesting repetitive minor compression as the likely cause. Ultrasonography and magnetic resonance imaging demonstrated a pseudoaneurysm of the digital artery. Intraoperative angiography confirmed the pseudoaneurysm and robust collateral circulation, allowing safe excision without the need for vascular reconstruction or vein grafting. Postoperative perfusion remained intact, and at 5 months postoperatively, there was no recurrence of pseudoaneurysm. This case highlights that chronic, low-grade compression can cause digital pseudoaneurysm, even in children, and emphasizes the importance of including this entity in the differential diagnosis of pediatric finger masses, as well as the value of intraoperative angiography in planning minimally invasive, circulation-preserving treatment.