title: About a case of missed diagnosis of a post-traumatic aneurysm in the ulnar artery. Medical-legal aspects in respect to the professional liability.
abstract: Compartment syndrome of the left hand from a late diagnosed post-traumatic ulnar artery pseudoaneurysm. We report the case of 27 years old boy with a tipping and cutting wound on his left wrist, generating an ulnar artery pseudoaneurysm, that was late diagnosed, and therefore complicated by a compartment syndrome in the wrist. Immediately after the trauma the subject went to the emergency room where the severity of the injury was undestimated; in fact, it was sutured and medicated, without further investigation. When he went to the same hospital for the second time, symptoms (pulsatile mass, redness and irritation of the skin) were interpreted as an infectious process and treated in an incongruous way. Then, when he went to another hospital in which imaging studies (ultrasound) were performed, the pseudo- aneurysm of the ulnar artery was diagnosed and surgically treated. The delay in diagnosis led to a compartment syndrome that is still appreciable as a sensory-motor deficit of the hand, especially of the fourth and fifth finger. This pseudo- aneurysm complication and its debilitating outcomes are known in literature, so the diagnostic delay makes the sanitary staff guilty of the suffered damage.
authors.forename: Virginia
authors.initials: V
authors.lastname: Prezioso
authors.forename: Tatiana
authors.initials: T
authors.lastname: Mangiulli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bolino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Sciacca
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence*; D004886:Erysipelas / Q000175:diagnosis; D005511:Food Handling; D006406:Hematoma / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D016365:Liability, Legal; D008297:Male; D008318:Malpractice; D009069:Movement Disorders / Q000209:etiology*; D060051:Occupational Injuries / Q000150:complications*; D010292:Paresthesia / Q000209:etiology*; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D017769:Ulnar Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D014463:Ultrasonography; D014946:Wound Infection / Q000175:diagnosis; D014954:Wrist Injuries / Q000150:complications*