Sonographic Detection of Pseudoaneurysm From Ankle Sprain Injury

Abstract

Aneurysms and pseudoaneurysms, of the anterior tibial artery, are very rare. Pseudoaneurysms of the anterior tibial artery are commonly due to iatrogenic injury, blunt trauma, fracture, or sharp penetrating injury. A young man presented to a pediatric emergency department with a pseudoaneurysm of the left anterior tibial artery due to an ankle sprain injury. Radiography, magnetic resonance imaging, and duplex sonographic imaging were completed to rule out all previously suspected diagnoses, and ultimately duplex sonography diagnosed and characterized the pseudoaneurysm. The utilization of duplex sonography in the investigation and diagnosis of injuries, particularly with extensive soft tissue swelling, provided quick diagnostic information and an expedited treatment plan. Conservative observation was initially attempted, followed by sonographic compression, sonography-guided thrombin injection, vessel ligation, and coil embolization. After initial treatment attempts failed, the patient was transferred to an adult hospital, with a specialized vascular surgery team, for vessel ligation and ultimate successful treatment with coil embolization.