Chronic leg swelling and palpitation as a late complication of post-traumatic arteriovenous fistula: A case report

• Published in: Trauma case reports Vol. 2; pp. 16 - 20
• Main Authors: Kalender, Mehmet, Baysal, Ahmet Nihat, Dagli, Mustafa, Gokmengil, Hayat
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-02-2016; Elsevier
• Subjects: Arteriovenous fistula; Cardiovascular disease; Lower extremity; Surgery; Trauma; Cardiovascular disease; Arteriovenous fistula; Lower extremity; Trauma
• ISSN: 2352-6440; 2352-6440
• DOI: 10.1016/j.tcr.2016.03.004

Abstract Introduction Chronic post-traumatic arteriovenous fistula (AVF) is a late complication of vascular injury and can be presented with symptoms of congestive heart failure, venous hypertension and distal ischaemia. We present an unusual case of chronic leg swelling in adult caused by post-traumatic AVF. Case presentation A 52 year old white-male patient complained of palpitation, pain and swollen right leg. Arterial pulses distally from the groin were present. His medical history revealed him to have sustained gunshot injury of the left thigh 5 years before. Angiography showed a large AVF between superficial femoral artery and femoral vein. The patient underwent surgical repair of AVF with ligation of AVF between superficial femoral artery under spinal anaesthesia. Completion angiography confirmed AVF exclusion. Leg swelling healed within a month. Conclusion Post-traumatic fistula should be obliterated as soon as possible. Untreated fistula results in complications including renin-mediated hypertension and high-output heart failure, venous and/or arterial insufficiency.