This is a 20-year-old girl. She underwent a renal transplant when she was in standard 9 by me at apollo hospital Bhubaneswar. Now she has presented to us with a history of fever and acute pain and increased swelling in her upper arm. At av fistula site. With skin color change. On imaging, it showed. Impending rupture. Which is a life-threatening problem. As it is extremely difficult to control bleeding and a person can lose a lot of blood.
The cephalic vein just proximal to the fistula is normal in caliber for a length of approximately 6 cm with the patent flow.
Large partially thrombosed pseudoaneurysm approximately 6 cm from on the fistula site measuring approximately 5.5 x 4.1 cm. Surrounding soft tissue edema and mild fluid collection is likely suggestive of leaking Pseudoaneurysm.
A short segment of normal caliber cephalic vein team (approximately 3 cm) just proximal to the pseudoaneurysm.
Significant ectasia/ Pseudo aneurysm of the proximal cephalic vein over a length of approximately 11.2 cm with a maximum width of 4.8 cm.
The brachial artery was Repaired and excised the aneurysm part and unhealthy skin overlying it
Thanks to my Team at apollo hospital Bhubaneswar.
Dr Prateek Sahoo. Dr Ram. Mr Ashok and Mr Soumya.
Dr Mami Parija. Anesthesia
Dr. Ajit Biswal. Radiologist for providing a very accurate delineation of the pseudo aneurysm
