A year after being stabbed by scissors, an 8cm lump grows on the calf, and a doctor reveals a false aneurysm warning
A 57 year old man was accidentally stabbed in the left calf with scissors. After treatment, the external wound healed, but the vascular damage inside was not detected. Later, the surface of the calf bulged a bit, and after a year, it turned into a lump the size of an egg, so painful that I couldn't stand. When the doctor touched it, he found that the lump would bounce. After examination, the diagnosis was "pseudoaneurysm". Fortunately, after two surgeries, the bomb was successfully removed.
Chen Weihong, a cardiovascular surgeon at the Affiliated Hospital of Asian University, said that the patient had always had hypertension and diabetes, and his blood pressure was not well controlled. When he sought medical treatment, he said that after being injured in February last year, his left calf was easily sore and swollen. Later, even when walking or standing up from squatting, he felt that his leg lacked strength. The symptoms lasted for almost a year until the pain became unbearable before seeing a doctor.
During palpation, the physician found that the lump in front of the patient's left lower leg could be palpated with obvious pulsation. After blood tests, vascular ultrasound, and lower limb computed tomography, and comparing the ultrasound and computed tomography images, it was determined to be a "left anterior tibial artery pseudoaneurysm" with a lesion of approximately 8 by 4 centimeters, the size of an egg.
Chen Weihong said that a pseudoaneurysm does not actually grow a tumor. After the arterial wall is injured and ruptured, blood continues to leak from the rupture site to surrounding tissues, gradually being enveloped by soft tissue and fibrous membranes, forming a sac that communicates with the original artery and is filled with blood. The outer layer of pseudoaneurysm is not a complete vascular wall, but a thin film formed by surrounding tissue, so the structure is relatively fragile and the risk of rupture and bleeding is higher.
He judged that the patient had high blood pressure, and after the blood vessel was injured, the blood kept flowing out from the rupture under relatively high pressure, and the surrounding tissues could not effectively control the bleeding, ultimately forming a pseudoaneurysm.
The medical team initially used minimally invasive methods for treatment. They tried to inject embolic agents into the lumen of the pseudoaneurysm and used balloons to protect normal blood vessels, preventing the drugs from flowing to the distal end and causing vascular obstruction. But because the tumor cavity was too large to completely block, after evaluation, it was decided to switch to traditional surgery. During the surgery, cut open the muscle, avoid the surrounding nerves, locate the damaged artery, remove the pseudoaneurysm, and remove the blood clot inside. The physician also removed a segment of the great saphenous vein from the right thigh to replace the damaged anterior tibial artery. The surgery takes about 8 hours, and it is confirmed after surgery that the reconstructed blood flow has returned to normal.
