Traumatic femoral arteriovenous fistula following gunshot injury: Case report and review of literature

Annals of Medicine and Surgery
Youssef ShabanDessy Boneva

Abstract

Vascular injuries account for approximately 2-4% of trauma admissions with only 2.5% of these being traumatic arteriovenous fistulas (AVFs). We offer a case report of a traumatic AVF and review of the literature. A 40-year-old male presented following 4 gunshot wounds, 2 in the forearm and 2 in the left upper thigh. The patient had decreased range of motion and paresthesia of the left lower extremity with palpable pulses and adequate capillary refill in all extremities. A CT angiogram demonstrated a left traumatic AVF involving the left deep femoral artery and left common femoral vein with an adjacent bullet fragment. The patient was taken to the operating room and underwent an exploration of the left groin, repair of the traumatic AVF, and removal of bullet fragment. The venous aspect had a grade IV injury and was ligated. The arterial defect was debrided to healthy tissue and repaired primarily. The patient recovered from his injuries with adequate ambulation and resolution of lower extremity edema. He was discharged home on postoperative day 4 on aspirin and a compression stocking. Traumatic AVFs are rare, with up to 70% diagnosed in a delayed fashion. Clinicians must maintain a high index of suspicion to correctly diagnose ...Continue Reading

References

Oct 1, 1992·The Journal of Trauma·J A Yelon, T M Scalea
Sep 1, 1994·The British Journal of Surgery·J V RobbsM Mars
Feb 22, 2007·AJR. American Journal of Roentgenology·Jennifer K ChenElliot K Fishman
Mar 20, 2010·Journal of Vascular Surgery·Mohammed ChaudryDavid G Neschis
Apr 12, 2011·Journal of Vascular Surgery·Randall W FranzMichelle L Wright
Jan 1, 2008·The International Journal of Angiology : Official Publication of the International College of Angiology, Inc·Kamal NagpalRj Cuschieri
Mar 1, 2015·Annals of Vascular Surgery·Calvin J YoungCassius I Ochoa Chaar
Oct 21, 2016·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group
Jan 26, 2018·The Journal of Trauma and Acute Care Surgery·Nathan R ManleyJohn P Sharpe

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