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Saad N, Bentalha A, Thar A, Benjelloun MY, Oulahyane R, Mossadik A, El Koraichi A, El Kettani S. Spontaneous rupture of a posttraumatic aneurysm of the axillary artery-a rare cause of hemorrhagic shock in children. Ann Vasc Surg 2014; 28:1792.e15-7. [PMID: 24704582 DOI: 10.1016/j.avsg.2014.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/09/2014] [Accepted: 03/10/2014] [Indexed: 10/25/2022]
Abstract
Posttraumatic aneurysms of the axillary artery are extremely scarce. In pediatrics, no similar case has been described. Injuries of axillary artery are often associated with ischemic complications, whereas the bleeding risks are not well documented. We report the case of a 5-year-old boy who was admitted with a scapular pulsatile lump 2 weeks after a domestic accident. During his stay, he suddenly presented a hemorrhagic shock. The patient was immediately admitted to the operating room to undergo surgical hemostasis and was then transferred to intensive care unit to stabilize his vital functions. This case shows the possibility of spontaneous and life-threatening acute bleeding of posttraumatic aneurysms of the axillary artery.
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Affiliation(s)
- Nabil Saad
- Pediatric ICU, Children Hospital, Rabat, Morocco
| | - Aziza Bentalha
- School of Medicine, Mohamed V University, Rabat, Morocco
| | | | | | - Rachid Oulahyane
- Pediatric ICU, Children Hospital, Rabat, Morocco; Pediatric General Surgery Department, Children Hospital, Rabat, Morocco
| | - Ahlam Mossadik
- Pediatric ICU, Children Hospital, Rabat, Morocco; School of Medicine, Mohamed V University, Rabat, Morocco
| | - Alae El Koraichi
- Pediatric ICU, Children Hospital, Rabat, Morocco; School of Medicine, Mohamed V University, Rabat, Morocco.
| | - Salma El Kettani
- Pediatric ICU, Children Hospital, Rabat, Morocco; School of Medicine, Mohamed V University, Rabat, Morocco
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Hildingsson C, Toolanen G, Hedlund T. Late vascular complication after fracture of the proximal humerus. Arch Orthop Trauma Surg 1996; 115:357-8. [PMID: 8905113 DOI: 10.1007/bf00420332] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A case of late vascular complication after a fracture of the proximal humerus is presented. The main clinical feature was neurological loss of the brachial plexus, while angiography showed no rupture or false aneurysm. The long delay before surgical intervention caused irreversible damage to the nerves. Early diagnosis and surgical intervention are emphasized.
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Affiliation(s)
- C Hildingsson
- Department of Orthopaedics, University Hospital, Umeå, Sweden
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Emadian SM, Lee WW. Axillary artery pseudoaneurysm and axillary nerve palsy: delayed sequelae of anterior shoulder dislocation. Am J Emerg Med 1996; 14:108-9. [PMID: 8630137 DOI: 10.1016/s0735-6757(96)90034-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Affiliation(s)
- M Veilleux
- Division of Neurology, Montreal General Hospital, Quebec, Canada
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Abstract
Five months after dislocation of the left shoulder a 66-year-old patient noted a swelling in the left axilla. After CT-scan a malignant tumour was suspected and an incisional biopsy was performed. A week later the patient died due to hemorrhaging from the biopsy wound. The autopsy revealed a false aneurysm of the axillary artery. The incision had damaged the external wall of the aneurysm leading to consecutive rupture. Post-mortem findings are presented.
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Affiliation(s)
- K H Schiwy-Bochat
- Institute of Forensic Medicine, Aachen University of Technology, Germany
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Abstract
Isolated avulsion fractures of the lesser tuberosity are extremely rare. A 24-year-old woman fell on her back as her arm was forcibly extended and adducted. Radiographs revealed a small fragment of bone beneath the glenoid. Axillary radiography showed the bone fragment and a bone defect of the lesser tuberosity. Computed tomography scan clearly demonstrated those findings. Surgery was performed 3 weeks after the occurrence of the injury. The bone fragment was reduced and fixed by means of two screws. After 3 weeks, light exercise was started. At follow-up 7 months later she had no complaints. Most reported cases involved sudden contraction of the subscapularis tendon. This type of fracture is sometimes misdiagnosed; computed tomography scan is useful for diagnosis. Previously reported cases have similarly demonstrated a good outcome after surgery, except in cases involving children.
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