[Complications of antecubital arteriovenous fistula]

A serious complication following the insertion of an a-v shunt for dialysis in a 41-year-old man is reported. Three weeks after the operation, arterial and venous circulatory disturbances occurred in the hand, accompanied by cyanosis distally of the shunt and a lymphatic fistula in the operated cubical area, and followed by the symptoms of a compartment syndrome in the forearm with impaired mobility of the hand. In order to restore normal hemodynamic conditions, the shunt was interrupted and the infected area covered by a local flap. Several weeks later a false aneurysm developed and the circulation had to be reconstructed by an extra-anatomic vein graft. At present the hand is functionally fully rehabilitated.