title: Axillary arteriovenous fistula after axillary plexus block.
abstract: This report presents the case of a 51-year-old man who had an axillary arteriovenous fistula (AVF) as a complication of an axillary plexus block that was performed for internal fixation for a right forefinger phalanx fracture 4 years previously. While performing the axillary plexus block, a 22-gauge needle was placed inside the axillary sheath by observing the pulsations of the axillary artery. A pulsatile mass was found in the right axilla 1 day after the block was performed. Apart from this soft mass, the patient had no symptoms of vascular nerve damage. As the mass gradually increased in size, it became painful. During the past 3 months, in particular, the patient experienced repeated attacks of intermittent sharp pain and requested surgery. Digital subtraction angiography, performed 4 years after the axillary block, showed a tumor-like dilation was developing in both the right axillary artery and vein, almost simultaneously. Thus, the diagnosis of AVF was confirmed. The false aneurysm sac was excised and lateral repair of the axillary artery and vein was carried out under general anesthesia. Postoperative recovery was uneventful. The possible occurrence of an AVF after axillary plexus block should be kept in mind, because early diagnosis and treatment are necessary to avoid development of AVF and false aneurysm.
authors: Department of Hepatobiliary Pancreatic Surgery, Jinhua Municipal Central Hospital, 321000, Jinhua, Zhejiang Province, People's Republic of China.
authors: Dao-Jun
authors: DJ
authors: Gong
authors: Hai-Jun
authors: HJ
authors: Yuan
authors: Zhong-Heng
authors: ZH
authors: Zhang
mesh_terms: D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000601:surgery; D001365:Axilla / Q000293:injuries / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*