A CASE OF ARTERIOVENOUS FISTULA OF THE LOWER EXTREMITY CAUSED BY BLUNT TRAUMA

We report a intersting case of arteriovenous fisula of the lower extremity caused by blunt trauma. A 34-year-old man presented to a hospital because of a left lower leg tumor. At age 32, he had sustained a bruise on his lower leg with a soft ball while playing baseball. He had noticed an elastic, hard, large tumor about 8×7cm in the medial porfrom of the lower leg on the left. The tumor showed no pulsation but we detected blood flow in the tumor with color Doppler imaging. Angiography revealed a microfistula type of arteriovenous fistula suppled by feeding arteries from muscle branches of the posterior tibial and peroneal arteries. CT scan of the lower leg revealed a remarkably dilated vessel including an arteriovenous communication. Under an Esmarch bandage, a 15cm longitudinal skin incision was made inthe sural region. The arteriovenous fistula was easily removed. The patient has has an uneventful course for one year and eight months, to date. We describe this interesting case of arteriovenous fistula of the lower extremity caused by trauma.