title: Emergency bedside sonographic diagnosis of subclavian artery pseudoaneurysm with brachial plexopathy after clavicle fracture.
abstract: Clavicle fractures are common; however, complications are unusual. Two such complications, subclavian artery pseudoaneurysm and brachial plexopathy, are rare events that can cause significant morbidity and mortality. We report the case of a 53-year-old man who presented with shoulder swelling and right arm weakness for 1 week. Three weeks before, he had fallen and fractured his right clavicle. On presentation to our emergency department, his examination revealed a brachial plexopathy and a large supraclavicular mass. An emergency bedside triplex sonogram was performed to characterize the mass and revealed a swirling pattern within a fluid collection anterior to the subclavian artery, suggestive of a pseudoaneurysm. After computed tomography-angiography, the patient was taken to the operating room, where he underwent hematoma washout and subclavian artery stent-graft placement. This case illustrates how bedside point-of-care sonography can rapidly assist in the initial assessment of subclavian artery injury.
authors: Department of Emergency Medicine, University of Virginia, Charlottesville, USA. jennifer.landers@gmail.com
authors: Jennifer
authors: J
authors: Gullo
authors: E M
authors: EM
authors: Singletary
authors: Shannon
authors: S
authors: Larese
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000209:etiology*; D002968:Clavicle / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography