Yilmaz Serdar, Cankaya Deniz, Deveci Alper, Ozkurt Bulent, Simsek Mehmet Emin, Tabak Abdullah Yalcin, Bozkurt Murat
Department of Orthopaedics and Traumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Orthopaedics and Traumatology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
Case Rep Orthop. 2014;2014:961691. doi: 10.1155/2014/961691. Epub 2014 Dec 25.
Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH). Magnetic resonance imaging (MRI) is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115 × 107 × 196 cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery.
由手术或外伤引起、持续且缓慢扩大超过一个月的血肿被定义为慢性扩展性血肿（CEH）。磁共振成像（MRI）对其诊断有用。完整切除假包膜是治疗方法。假性动脉瘤由动脉壁破裂引起，可能被误诊为CEH。我们报告一例罕见病例，一名45岁男性，左腘窝有一个巨大、疼痛性肿胀。他11年前被钉子刺伤，腘窝出现逐渐增大的肿块。一年后检测到假性动脉瘤并进行了手术。术后，腘窝再次出现逐渐增大的肿块。血管造影显示腘动脉闭塞，通过侧支血管维持血流。MRI显示直径达115×107×196cm的巨大肿胀。诊断为CEH，在保护侧支血管的情况下将其完全切除，术后一年无复发。
