title: Arteriolymphatic Fistula: An Unusual Cause of Spontaneous Swelling in the Left Supraclavicular Region.
abstract: An abnormal fistulous communication between an artery and lymphatic system is a rare occurrence. We report a 38-year-old male presenting with sudden onset, spontaneous, pulsatile swelling in the left supraclavicular region following a recent cardiac catheterisation via right femoral arterial access. On evaluation, he was found to have a femoral arteriolymphatic fistula. He was managed conservatively with ultrasound-guided compression with complete resolution of symptoms at follow-up. This case describes a hitherto unknown complication of percutaneous vascular cannulation presenting in an unusual manner, diagnosed with Doppler Ultrasonography and CT angiography and managed effectively with a non-invasive therapeutic image-guided manoeuvre.
authors.affiliation: Department of Radiology, Christian Medical College Hospital, Vellore, India.
authors.forename: Ashok Mithra
authors.initials: AM
authors.lastname: Karuppiah Viswanathan
authors.affiliation: Department of Radiology, Christian Medical College Hospital, Vellore, India.
authors.forename: Aparna
authors.initials: A
authors.lastname: Irodi
authors.affiliation: Department of Radiology, Christian Medical College Hospital, Vellore, India. aparna_shyam@yahoo.com.
authors.forename: Shyamkumar N
authors.initials: SN
authors.lastname: Keshava
authors.affiliation: Department of Medicine, Christian Medical College Hospital, Vellore, India.
authors.forename: Joseph
authors.initials: J
authors.lastname: Aneez
authors.affiliation: Department of Medicine, Christian Medical College Hospital, Vellore, India.
authors.forename: Gunasekaran
authors.initials: G
authors.lastname: Karthik
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002968:Clavicle / Q000098:blood supply / Q000000981:diagnostic imaging*; D000072226:Computed Tomography Angiography; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D011312:Pressure; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional
keywords: Arteriolymphatic fistula; CT angiography; Femoral arterial access; USG Doppler