Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.003315
Jornal Vascular Brasileiro
Case Report

Trauma inguinal penetrante com formação de fístula arteriovenosa e pseudoaneurisma: relato de caso

Acquired arteriovenous fistula and pseudoaneurysm secondary to penetrating inguinal trauma: a case report

Frederico Michelino de Oliveira; Ary Augusto Reis de Macedo; Adolfo Palhares Matheus Rodrigues; Jamil Jorge Abou Mourad; Ary Augusto de Castro Macedo; Lia Ormieres Costa; Paulo Eduardo Lucisano Bin

http://dx.doi.org/10.1590/1677-5449.003315 J Vasc Bras, vol.14, n4, p.364-367, 2015
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Resumo

Resumo Os autores apresentam um relato de caso de vítima de acidente de trabalho com ferimento penetrante em região inguinal direita com peça metálica em espiral, que evoluiu com fístula arteriovenosa da artéria femoral profunda com a veia femoral profunda associado a pseudoaneurisma envolvendo essas estruturas e a veia femoral comum. As fístulas arteriovenosas ocorrem frequentemente após traumas e a associação com pseudoaneurisma é fato raro, devendo ser tratadas precocemente após seu diagnóstico. O ultrassom duplex é atualmente o exame mais utilizado para a avaliação inicial e a arteriografia, o padrão ouro para diagnóstico. No paciente em questão foi realizado tratamento convencional com abordagem cirúrgica direta, sutura arterial e ligaduras venosas. Entretanto, nos dias atuais a cirurgia endovascular e a compressão guiada por ultrassom são métodos terapêuticos que têm sido utilizados com sucesso. O paciente evoluiu sem intercorrência, recebendo alta para acompanhamento ambulatorial com preservação do membro.

Palavras-chave

fístula arteriovenosa, pseudoaneurisma, ferimentos penetrantes

Abstract

Abstract This article describes the case of a work accident victim with a penetrating wound to the right inguinal region caused by a metal spiral. The patient developed an arteriovenous fistula between the deep femoral artery and deep femoral vein, combined with a pseudoaneurysm surrounding these structures and the common femoral vein. Arteriovenous fistulas frequently occur after traumas, but the combination of fistula and pseudoaneurysm is rare. It is recommended that they be treated immediately after diagnosis. Duplex ultrasound is the most widely used method for initial assessment and arteriography is the gold standard for diagnosis of arteriovenous fistulas. Endovascular surgery has recently been used successfully in such cases. However, this patient was treated conventionally using a direct surgical approach, arterial suture and venous ligatures, and the limb was saved. The patient developed no complications and was discharged to outpatients follow-up.

Keywords

arteriovenous fistula, pseudoaneurysm, wounds, penetrating

References

Girolami A, Foex B, Little R. Change inte causes of trauma in the last 20 years. Trauma. 1999;1(1):3-11.

Compton C, Rhee R. Peripheral vascular trauma. Perspect Vasc Surg Endovasc Ther. 2005;17(4):297-307.

Demetriades D, Murray J, Sinz B. Epidemiology of major trauma and trauma deaths in Los Angeles County. J Am Coll Surg. 1998;187(4):373-83.

Isselbacher EM. Doenças da aorta. CECIL Tratado de Medicina Interna. 2005;1.

Stahlke Junior HJ, Colpo PG, Jacobovicz C, Stahlke PH, Souza DF, Araujo WJB. Fistulas arteriovenosas traumaticas tardias: revisão de 154 operados. RevAngiolCir Vasc.. 2005;5:223-30.

Erkut B, Karapolat S, Kaygin MA, Unlu Y. Surgical Treatment of post-traumatic pseudoaneurysm and arteriovenous fistula due to gunshot injury. Ulus Travma Acil Cerrahi Derg. 2007;13(3):248-50.

DeBakey ME, Simeone FA. Battles injury of the arteries of the World War II, an analusis of 2471 cases. Ann Surg. 1946;123:534-79.

Rich NM, Baugh JH, Hughes CW. Acute arterial injuries in Vietman; 1000 cases. J Trauma. 1970;10(5):359-69.

Mullenix PS, Steele SR, Andersen CA, Starnes BW, Salim A, Martin MJ. Limb salvage and outcomes among patients withtraumatic popliteal vascular injury: an analysis of the NationalTrauma Data Bank. J Vasc Surg. 2006;44(1):94-100.

Lebreton G, Uzel AP, Celerien J, Roques F, Deneuville M. Popliteal arteriovenous fistula due to a gunshot injury. Ann Vasc Surg. 2010;24(7):952.e17-21.

Megalopoulos A, Siminas S, Trelopoulos G. Traumaticpseudoaneurysm of the popliteal artery after blunt trauma: case report and a review of the literature. Vasc Endovasc Surg. 2007;40:499-504.

Rich N, Spencer F. Arteriovenousfistulas. Vascular Trauma. 1978;53:191-232.

Davidovic LB, Banzić I, Rich N, Dragaš M, Cvetkovic SD, Dimic A. False traumatic aneurysms and arteriovenous fistulas: retrospective analysis. World J Surg. 2011;35(6):1378-86.

Nara T, Yoshikawa D, Saito S, Kadoi Y, Morita T, Goto F. Perioperative menagement of biventricular failure afther closure of a long-standing massive arteriovenous fistula. Can J Anaesth. 2001;48(6):588-91.

Aldridge SC, Comerota AJ, Katz ML, Wolk JH, Goldman BI, White JV. Popliteal venous aneurysm: report of two cases andreview of the world literature. J Vasc Surg. 1993;18(4):708-15.

Kron J, Sutherland D, Rosch J, Morton MJ, McAnulty JH. Arteriovenous fistula: a rare complication of arterial puncture for cardiac catheterization. Am J Cardiol. 1985;55(11):1445-6.

Feld R, Patton GM, Carabasi A, Alexander A, Merton D, Needleman L. Treatment of iatrogenic femoral artery injuries with ultrasound-guided compression. J Vasc Surg. 1992;16(6):832-40.

Schaub F, Theiss W, Heinz M, Zagel M, Schömig A. New aspects in ultrasound-guided compression repair of postcatheterization femoral artery injuries. Circulation. 1994;90(4):1861-5.

Paulson EK, Kliewer MA, Hertzberg BS. Ultrasonographically guided manual compression of femoral artery injuries. J Ultrasound Med. 1995;14(9):653-9.

Stewart DK, Brown PM, Tinsley Jr EA, Hope WW, Clancy TV. Use of stent grafts in lower extremity trauma. Ann Vasc Surg. 2011;25(2):264.e9-13.

Bokhabrine MK, Bouziane Z, Lahlou Z, Lekhal B, Bensaid Y. Fistules artérioveineuse post-traumatiques des membres: expérience de 26 cas. Ann Cardiol Angeiol. 2010;59(2):67-71.

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