Pediatric ulnar artery pseudoaneurysm of the wrist after glass laceration: A case report and systematic review of the literature

Abstract

Background Our purpose was to explore a case of a complicated ulnar artery pseudoaneurysm and propose an algorithm to guide physicians in this scenario. We present a case of a 5‐year‐old boy with a pediatric ulnar artery pseudoaneurysm that developed after a wrist laceration from broken glass 6 weeks after the initial injury. The diagnosis of pseudoaneurysm was missed, and the patient was transferred to our facility in urgent need of resection and repair due to profuse bleeding. An ultrasound confirmed the suspected diagnosis of ulnar artery aneurysm with thrombosis within the vessel. An area of skin necrosis was also present. Upon exploration of the wound, the ulnar artery pseudoaneurysm was identified and resected. The defect measured six millimeters and it was repaired primarily, under the microscope, after the proximal and distal portions were freed by dissection. The patient's incision was well healed at six‐week follow‐up. Method A systematic literature review of the English literature on ulnar artery aneurysm was conducted on PubMed/Medline, Embase, Cochrane Clinical Answers, and Cochrane Clinical Trials, without timeframe limitations. Finally, we provide an algorithm to assist the decision‐making process in similar scenarios. Conclusion Although ulnar artery aneurysm is rare on a pediatric patient, it should be considered in the differential diagnosis each time a patient presents with a wrist mass. In such cases, a high index of suspicion warrants examination by a hand specialist.

Nontraumatic Pseudoaneurysm of the Deep Palmar Arch in a 10-Month-Old Infant

“…Very few cases of pseudoaneurysms in the hand or wrist of children have been documented 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] . Nearly, all previously reported pseudoaneurysms were caused by hand trauma except for 3 cases that were found to be congenital [4][5][6] .…”

From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery

“…For instance, Kubo et al mention that 5-30% of all free-tissue transfers and implantations are complicated by thrombosis [ 2 ]. While flaps with higher vascular resistance thrombose more frequently, Forte et al emphasized decreased complications in flaps with higher blood flow velocities [ 6 ]. This statistic is amongst many alarming findings involving thrombosis within plastic surgery procedures.…”