Digital Artery Aneurysm - Case Report.

INTRODUCTION AND METHODS

A 71-year-old patient, housewife, with a history of hypertension, elevated cholesterol and hypotyroidism was referred to the outpatient clinic for tumefaction of the right hand 5th finger noticed 3-4 months earlier. She denied past or recent history of trauma, cardiac or infectious disease and had no familial history of aneurysmatic disease. She was asymptomatic except for local slight discomfort when she had to press or push something with her hand. She had no sensitivity or mobility impairment. On examination a round, soft, pulsatile mass in the lateral aspect of the 5th finger was evident. All peripheral pulses were palpable with no evidence of abnormal or augmented pulsatility or thrill. Her peripheral pulses were palpable and symmetrical and didn't have augmented abdominal pulsatility. An ultrasound scan revealed a round mass measuring 14x7mm, having high intensity and pulsatile flow inside with turbulence suggesting aneurysm of or related with the proper digital artery.

RESULTS

She was submited to ressection of the aneurysm under digital nerve block and use of a ring tourniquet at the finger base. An oblique incision was made and under carefull dissection the aneurysm was disclosed and extirped after control and ligation of the inflow and outflow vessels. Eight months after surgery the patient remained asymptomatic with no signs of local recurrence. Hystologic examination revealed a sacular aneurysmatic formation surrounded by papillary endothelial hyperplastic lesions.

CONCLUSION

Digital artery aneurysms are very rare and most related with occupational or sports trauma. They are recognized sometimes by causing local discomfort or neurological symptoms due to nerve compression. Most cases can be treated by straight ressection after ligation of proximal and distal contiguous vessels taking care not to compromise flow to the distal finger.