Venous ulcer: late complication of a traumatic arteriovenous fistula.
Arteriovenous fistula (AVF) formation after penetrating trauma is a well-described phenomenon. However, diagnosis of traumatic AVF is frequently delayed as patients often do not have hard signs of vascular injury at the initial presentation. Late complications of traumatic AVF include arterial and venous dilatation, distal ischemia, venous congestion, and congestive heart failure. This case report describes a traumatic femoral AVF causing distal venous ulceration 3 years after the injury. The AVF was treated with open repair. In the operating room, the Nicoladoni-Branham sign was elicited. The ulcer healed at 1 month and has not recurred at 1-year follow-up.
Department of Surgery, Yale School of Medicine, New Haven, CT, USA. Electronic address: calvin.young@yale.edu.
Calvin J
CJ
Young
Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Alan
A
Dardik
Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Bauer
B
Sumpio
Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Jeff
J
Indes
Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Bart
B
Muhs
Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Cassius I
CI
Ochoa Chaar
D000328:Adult; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014945:Wound Healing; D014948:Wounds, Gunshot / Q000150:complications* / Q000175:diagnosis