外傷による足底仮性動脈瘤の1例

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Post-traumatic false aneurysms of the foot are not seen frequently. Recently we experienced one case of an 8 years old boy, who was injured in his left foot sole by a sharp piece of glass, and the skin was sutured as an initial treatment. Twelve days and 22 days after the accident, bleeding from the wound was observed, and then a pulsating mass was present on that region. Suspecting the false aneurysm, he was advised to visit our hospital.In the lateral side of the foot sole, there was a wound of which shape was like a character "V" of its one side about 2.5cm and the laceration edge was slightly opened.On physical examination a pulsating mass was noted in the proximal side of the wound.At the time of operation, between the tear edges of the plantar aponeurosis, an aneurysm of the lateral plantar artery was found and was resected without vascular reconstruction. Recovery was uneventful.The histological examination showed a false aneurysm because the wall of the aneurysm was not stained purple black with the Elastica Van-Gieson's stain.If there is sufficient space in the foot to form hematoma, which results from disruption of an arterial wall, especially a longitudinal tear of the artery, and from recurrence of bleeding, the development of a false aneurysm will often occur. So we concluded that it is important to ascertain the injured artery and to do an appropriate treatment for it initially.
西日本整形・災害外科学会の論文