CASE REPORT

Pulsatile pseudoaneurysm: a delayed diagnosed with a risk of limb ischemic in toddler: a case report

Yopie Afriandi Habibie , Vera Anggraini

Yopie Afriandi Habibie
Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Syiah Kuala, Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia. Email: [email protected]

Vera Anggraini
Apprentice General Practitioner, Faculty of Medicine Universitas Syiah Kuala, Dr. Zainoel Abidin General Hospital Banda Aceh Indonesia
Online First: April 30, 2021 | Cite this Article
Habibie, Y., Anggraini, V. 2021. Pulsatile pseudoaneurysm: a delayed diagnosed with a risk of limb ischemic in toddler: a case report. Bali Medical Journal 10(1): 425-428. DOI:10.15562/bmj.v10i1.2311


Background: Pseudoaneurysm is a vascular injury complication in lower extremity that’s rarely been reported, especially in toddlers. Should it not appropriately treated, it can lead to worst conditions and even limb ischemic.

Case description:  a 3-year-old toddler, presented in the emergency room (ER) of Dr. Zainoel Abidin General Hospital (RSUZA) with bleed wound in the left limb persistent active bleeding. The shattered glass hit the patient On the physical examination, we found bleeding wound on the medial malleolus region of left limb, a pulsatile mass on the palpation, history of active bleeding was positive. To confirm the diagnosis, we performed CT angiography showing a sac shaped vascular lesion measuring 2.8 x 2.2 x 2.8 cm of proximal segment of the left posterior tibial artery, suggesting a pseudoaneurysm. We performed open surgery with excision procedure and a clot was found in medial malleolus region. As a result of open surgery, the left medial malleolus region is red, indicating a good blood flow and the patient discharged from hospital 4 days after surgery with a good result.

Conclusion: Pseudoaneurysm resulting from vascular injury  or iatrogenic injury can lead on various serious complications. If pseudoaneurysm is not appropriately treated, it can even threaten the patient’s life.

 

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