Subclavian Artery Pseudoaneurysm Formation 3 Months after a Game of Rugby Union

Abstract

Pseudoaneurysms of the subclavian artery remain a rare complication after fracture of the clavicle. We report a case of delayed diagnosis of a subclavian artery pseudoaneurysm after a closed fracture of the clavicle in a 15-year-old patient, 3 months after the original injury while playing rugby union. Despite several attendances to the Emergency Department with vague symptoms, the final diagnosis was confirmed by duplex ultrasound and Computed Tomography of the thorax. Surgical repair was indicated due to acute limb ischaemia from distal embolisation from a large pseudoaneurysm, with the patient making a full recovery. This case highlights the need for clinical vigilance when assessing patients, particularly on repeated occasions when their recovery appears to be impaired. A thorough history and clinical examination can raise suspicion of even rare occurrences and aid prompt management.

Open Surgical Approach for Type II Endoleak in Subclavian Artery Pseudoaneurysm Presented With Neurological Symptoms After Endovascular Repair

“…11 Early complications have been described with patients presenting within months of a clavicular fracture with a pulsatile mass and hand ischemia. 12,13 The development of late neurologic symptoms from subclavian artery pseudoaneurysm following clavicular fracture is a rare presentation as well. Both the studies by Watanabe and Matsumura, and Tachtsi et al describe open repair of a subclavian artery pseudoaneurysm causing nerve compression several years after the clavicle fracture.…”