Dey Subhajeet, Baruah Anil, Mohanta Pradip Kumar
Sikkim Manipal Institute of Medical Sciences, 5th Mile, Tadong, Gangtok, 737102, India.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2008.0080. Epub 2009 Apr 29.
A 40-year-old man presented with a progressively increasing swelling over the ventral aspect of the right wrist of 23 days duration following a laceration. The swelling was soft, pulsatile and was intermittently bleeding, with poor distal capillary filling and cold distal extremity. Clinically it was diagnosed as pseudoaneurysm of the radial artery and was sent for a duplex scan for confirmation. The lesion ruptured in the radiology department before the scan was done, and the patient went into hypovolaemia. In view of this, the patient underwent exploration of the pseudoaneurysm under brachial block, and the radial artery was found to be transected just proximal to the dorsal branch. It was decided to repair the artery as there was no evidence of adequate circulation supply or the patency of the ulnar artery preoperatively. Doppler study at 15 and 45 days postoperatively showed good flow through, with no evidence of thrombus.
一名40岁男性，在右手腕掌侧因撕裂伤出现逐渐增大的肿胀23天。肿胀质地柔软、有搏动且间歇性出血，远端毛细血管充盈差，远端肢体发凉。临床诊断为桡动脉假性动脉瘤，遂行双功超声扫描以确诊。扫描前病变在放射科破裂，患者出现低血容量。鉴于此，患者在臂丛阻滞下行假性动脉瘤探查术，发现桡动脉在背侧分支近端完全离断。因术前未发现尺动脉有足够的血供或通畅迹象，故决定修复动脉。术后15天和45天的多普勒检查显示血流良好，无血栓形成迹象。
