Unknown AV-fistula as reason for post-traumatic hematoma of the thigh.
A case is reported of a 28-year-old patient with gradually developing massive swelling of the right thigh after sustaining a blunt trauma. 3 1/2 months after the injury, surgery was performed because of a persisting tumor at the thigh. Intraoperatively, massive bleeding occurred, the bleeding vessel was sutured. Postoperative angiography disclosed arteriovenous (av) fistulae from the internal iliacal artery to a gluteal vein as source for the bleeding. The feeding artery was closed by coiling, the patient recovered completely. To the authors' knowledge, development of an av-fistula following blunt trauma has not been described previously. Similarly, the differential diagnosis of a posttraumatic bleeding of a congenital av-malformation was not yet reported. The authors emphasize, that prior to the surgery of inadequately behaving hematomas, an angiography should be performed.
Bail
H J
HJ
Clinic for Trauma and Reconstructive Surgery, Charité, Campus Virchow Clinic, Humboldt University of Berlin, Germany. hermann.bail@charite.de
Melcher
I
I
Raschke
M J
MJ
Schroeder
R J
RJ
Schaser
K D
KD
D000328:Adult; D000792:Angiography; D001164:Arteriovenous Fistula / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy; D002081:Buttocks / Q000098:blood supply*; D003288:Contusions / Q000150:complications* / Q000175:diagnosis; D004621:Embolization, Therapeutic; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007083:Iliac Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D013537:Sutures; D013848:Thigh / Q000098:blood supply / Q000293:injuries*; D014680:Veins / Q000002:abnormalities