DÄ internationalArchive17/2019An Inexplicable Pulsating Swelling of the Right Cubital Region

Clinical Snapshot

An Inexplicable Pulsating Swelling of the Right Cubital Region

Dtsch Arztebl Int 2019; 116(17): 300; DOI: 10.3238/arztebl.2019.0300b

Herold, J; Bauersachs, R

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A 75-year-old man was referred for angiological investigation of an inexplicable pulsating swelling of the right cubital region. No shunt had been inserted or other intervention carried out in the area of the swelling, neither was any scarring apparent. The patient reported that the swelling had originated gradually and with no apparent cause over the past 6 months. His right hand also often felt cool. Duplex sonography showed a well-perfused pseudoaneurysm (PSA; 3.5 × 1.0 × 0.8 cm) arising from the distal brachial artery. When the patient was questioned, it turned out that withdrawal of a blood sample from the right cubital region a year earlier had been painful. In the space of the intervening year, he had lost 25 kg due to colon cancer. His original obesity had concealed the pseudoaneurysm caused by the blood sampling. The pseudoaneurysm was treated successfully with an injection of thrombin and the patient was discharged a day later.

The photograph shows a pulsating swelling in the right cubital region (red arrows).
The photograph shows a pulsating swelling in the right cubital region (red arrows).
Figure B
The photograph shows a pulsating swelling in the right cubital region (red arrows).

PD Dr. med. habil. Joerg Herold, Prof. Dr. med. Rupert Bauersachs,
Klinik für Gefäßmedizin – Angiologie, Klinikum Darmstadt GmbH, joerg_herold@hotmail.com

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by David Roseveare.

Cite this as: Herold J, Bauersachs R: An inexplicable pulsating swelling of the right cubital region. Dtsch Arztebl Int 2019; 116: 300. DOI: 10.3238/arztebl.2019.0300b

The photograph shows a pulsating swelling in the right cubital region (red arrows).
The photograph shows a pulsating swelling in the right cubital region (red arrows).
Figure B
The photograph shows a pulsating swelling in the right cubital region (red arrows).