Tambuzzi Stefano, Gentile Guendalina, Ferraroli Lorena, Del Gobbo Alessandro, Zoja Riccardo
Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37, Milano, 20133, Italy.
Divisione di Patologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Forensic Sci Med Pathol. 2025 Jun 9. doi: 10.1007/s12024-025-01032-5.
Rupture of a pseudoaneurysm of the superficial palmar arch after surgical release of the carpal tunnel is an extremely rare and still debated occurrence. Only a few cases have been described in the literature, none of which were fatal. In this report, we present a single case that came to our attention, in which an elderly man suffered a fatal haemorrhage due to the rupture of a palmar pseudoaneurysm 22 days after surgical carpal tunnel release. Autopsy examination confirmed the presence of a breach in the large palmar hematoma as the sole source of bleeding. Histologic examination in some of the serial sections of the suprafascial hematoma revealed a ruptured arterial pseudoaneurysmal cavity. Based on these findings, the man's death could be attributed to acute haemorrhage due to the rupture of the palmar pseudoaneurysm. Further studies are required to investigate whether there is actually a causal link with the surgical release of the carpal tunnel but the current evidence suggest that this may be possible. The case is therefore reported to the forensic scientific community due to its exceptional occurrence and its potential implications.
腕管手术松解后掌浅弓假性动脉瘤破裂是一种极为罕见且仍存在争议的情况。文献中仅描述了少数病例，均未致命。在本报告中，我们介绍了引起我们注意的一例病例，一名老年男性在腕管手术松解22天后因掌部假性动脉瘤破裂而发生致命性出血。尸检证实大的掌部血肿存在裂口是唯一的出血来源。筋膜上血肿的一些连续切片的组织学检查显示有破裂的动脉假性动脉瘤腔。基于这些发现，该男子的死亡可归因于掌部假性动脉瘤破裂导致的急性出血。需要进一步研究以调查其与腕管手术松解之间是否实际存在因果关系，但目前的证据表明这是有可能的。因此，由于该病例的特殊情况及其潜在影响，现将其报告给法医学界。
