title: Subfascial hematoma progressed to arm compartment syndrome due to a nontransposed brachiobasilic fistula.
abstract: Vascular access-associated compartment syndrome is reported rarely in hemodialysis patients. A 62-year-old female hemodialysis patient experienced left-arm compartment syndrome caused by a nontransposed brachiobasilic arteriovenous fistula. A subfascial hematoma that developed because of perforation of the posterior wall of the basilic vein was not detected by Doppler ultrasound initially, and subsequent heparinized hemodialysis caused progression of the hematoma. Neuromuscular sequelae were prevented by performing an emergent fasciotomy, and transposition of the arterialized basilic vein was performed later to prevent similar complications in the future. This case report shows the risk for the occurrence of such a devastating complication if the nontransposed brachiobasilic fistula is used for hemodialysis vascular access.
authors.affiliation: Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Kang-Ling
authors.initials: KL
authors.lastname: Wang
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Chiao-Lin
authors.initials: CL
authors.lastname: Chuang
authors.forename: Tzen-Wen
authors.initials: TW
authors.lastname: Chen
authors.forename: Jinn-Yang
authors.initials: JY
authors.lastname: Chen
mesh_terms: D001132:Arm; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003161:Compartment Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D018450:Disease Progression; D000071938:Fasciotomy; D005260:Female; D006406:Hematoma / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed