Bauer Natasha J G, Hardy Simon C
Department of Vascular Surgery, Royal Blackburn Hospital, East Lancashire NHS Trust, Blackburn, UK
Department of Vascular Surgery, Royal Blackburn Hospital, East Lancashire NHS Trust, Blackburn, UK.
J Surg Case Rep. 2014 Jul 1;2014(7):rju068. doi: 10.1093/jscr/rju068.
A 60-year-old male patient was referred to the vascular clinic with a 2-week history of a 1.5 cm pulsatile tender swelling in the left hypothenar eminence. He worked as a gas fitter and sustained this swelling following an injury at work. Interestingly, unlike many cases reported, his left, non-dominant hand was only used passively while his dominant right hand was using the hammer. Duplex ultrasonography confirmed the presence of a true aneurysm of the left ulnar artery, measuring 11 mm in diameter, as it approached the palmar arch. The ulnar nerve was revealed to be ectatic and tortuous and was found to cork-screw in the palm. The aneurysm was removed surgically and histological specimens revealed an intraluminal organizing thrombus. The literature reveals that, in a true aneurysm, it is rare to present with symptoms of this syndrome in the non-dominant, passive hand.
一名60岁男性患者因左小鱼际隆起处出现一个1.5厘米搏动性压痛性肿块2周，被转诊至血管诊所。他是一名煤气装配工，在工作中受伤后出现了这个肿块。有趣的是，与许多报道的病例不同，他的左手（非优势手）只是被动使用，而优势右手正在使用锤子。双功超声检查证实，左尺动脉在接近掌弓处存在一个真性动脉瘤，直径为11毫米。发现尺神经扩张且扭曲，在手掌中呈螺旋状。通过手术切除了动脉瘤，组织学标本显示腔内有组织化血栓。文献表明，在真性动脉瘤中，非优势被动手出现这种综合征症状的情况很少见。
