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Q1: What is the diagnosis?
The diagnosis is pseudoaneurysm or false aneurysm of the radial artery. This is a leakage of the blood into the surrounding tissue with persistent communication between the artery and the blood filled cavity.
Q2: What are the differential diagnoses?
Haematoma, abscess, and true aneurysm mimic the pseudoaneurysm.
Q3: How do you treat this condition?
Uncomplicated cases are treated conservatively. They include (a) observation and compression bandage; (b) ultrasound guided compression; (c) ultrasound guided thrombin injection. Surgical intervention is reserved for complicated cases and patients who have failed conservative management.
Discussion
A pseudoaneurysm, is also referred to as false aneurysm. It is a leakage of blood from an artery into the surrounding tissue with persistent communication between the originating artery, and the terminating blood filled cavity. The arterial wall defect is referred to as the neck of the pseudoaneurysm. Unlike true arterial aneurysms, the three layers of the arterial wall do not bound pseudoaneurysms. The wall of the pseudoaneursym is composed of fibrous tissue, and when this exists for a prolonged period of time, the surrounding tissue may mature and resemble the arterial wall. Most pseudoaneurysms are iatrogenic in origin caused by an arterial catheterisation. The other causes include the anastomosis site of arterial bypass graft, infection, or direct...