Ate�li Silah Yaralanmas�ndan 24 Y�l Sonra Geli�en Dev Popliteal Arter Ps�doanevrizmas�: Nadir Bir Gecikmi� Vask�ler Komplikasyon

�ZDEM, Tayfun; demirk�ran, tuna; T�rko�lu, Baki; KARTAL, HAKAN; DEMIRDAS, ERTAN

31/9G�ncel Say� Ar�iv G�rsel �zetler Kapaklar Pop�ler Makaleler

ICMJE COI Form

H�zl� Arama

Scopus CiteScore

Ate�li Silah Yaralanmas�ndan 24 Y�l Sonra Geli�en Dev Popliteal Arter Ps�doanevrizmas�: Nadir Bir Gecikmi� Vask�ler Komplikasyon [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. Bask�daki Makaleler: UTD-55991

Ate�li Silah Yaralanmas�ndan 24 Y�l Sonra Geli�en Dev Popliteal Arter Ps�doanevrizmas�: Nadir Bir Gecikmi� Vask�ler Komplikasyon

Tayfun �ZDEM¹, tuna demirk�ran¹, Baki T�rko�lu², HAKAN KARTAL¹, ERTAN DEMIRDAS¹
¹Sa�l�k Bilimleri �niversitesi, G�lhane E�itim Ve Ara�t�rma Hastanesi, Kalp Ve Damar Cerrahisi Anabilim Dal�, Ankara, T�rkiye
²Sa�l�k Bilimleri �niversitesi, G�lhane E�itim Ve Ara�t�rma Hastanesi, Genel Cerrahi Anabilim Dal�, Ankara, T�rkiye

Popliteal arter ps�doanevrizmalar� nadir g�r�len ve travma sonras� gecikmi� bir komplikasyon olarak ortaya ��kabilen durumlard�r. Klinik semptomlar bazen ba�lang�� yaralanmadan y�llar sonra bile g�r�lebilir. Bu olguda, 24 y�l �nce ate�li silah yaralanmas� sonras� geli�en dev popliteal arter ps�doanevrizmas� olan dikkat �ekici bir vaka sunulmaktad�r. 71 ya��ndaki erkek hasta, sol popliteal b�lgede �i�lik ve hareket k�s�tl�l�� ikayetiyle ba�vurmu�tu. Hastan�n ayn� baca��na 24 y�l �nce kur�un yaras� ald��, ancak o d�nemde herhangi bir vask�ler komplikasyon tespit edilmedi�i ��renildi. Tan�sal g�r�nt�leme bu olguda kritik rol oynad�. Doppler ultrasonografi ve bilgisayarl� tomografi (BT) anjiyografi, 12 cm �ap�nda dev bir ps�doanevrizma ve kom�u tibia kemi�inde erozyon oldu�unu g�sterdi. Cerrahi eksplorasyon ile popliteal arter ps�doanevrizmas� tan�s� do�ruland�. Hasta, otolog safen ven grefti kullan�larak ba�ar�l� bir vask�ler rekonstr�ksiyon ge�irdi ve arteriyel devaml�l�k ile ekstremite fonksiyonu sa�land�. Bu olgu, ge� ba�vuran popliteal arter ps�doanevrizmalar�n�n tan�sal zorluklar�n� vurgulamaktad�r. Semptomlar y�llarca gizli kalabilece�inden, �zellikle travma �zerinden uzun zaman ge�mi�se bu vask�ler anomaliler g�zden ka�abilir veya yanl�� tan� alabilir. Bu bulgular, penetran ekstremite yaralanmas� olan hastalarda uzun s�reli ve dikkatli takibin �nemini ortaya koymaktad�r. Doppler ultrasonografi ve BT anjiyografi gibi uygun g�r�nt�leme y�ntemleri erken tan�, etkin tedavi i�in hayati �neme sahiptir. Zaman�nda cerrahi m�dahale, r�pt�r, ekstremite iskemisi veya kronik a�r� gibi ciddi komplikasyonlar� �nleyerek hasta sonu�lar�n� iyile�tirebilir.

Anahtar Kelimeler: Popliteal arter ps�doanevrizmas�, Gecikmi� vask�ler komplikasyon, Ate�li silah yaralanmas� sekeli, Safen ven grefti, Kronik travmatik anevrizma

A Giant Popliteal Artery Pseudoaneurysm 24 Years After Gunshot Trauma: A Rare Delayed Vascular Complication

Tayfun �ZDEM¹, tuna demirk�ran¹, Baki T�rko�lu², HAKAN KARTAL¹, ERTAN DEMIRDAS¹
¹University Of Health Sciences, Gulhane Training And Research Hospital, Department Of Cardiovascular Surgery, Ankara, Turkey
²University Of Health Sciences, Gulhane Training And Research Hospital, Department Of General Surgery, Ankara

Popliteal artery pseudoaneurysms are an uncommon and can present as a delayed complication resulting from trauma, with clinical symptoms that may not appear until many years after the initial injury. This report presents a remarkable case of a giant popliteal artery pseudoaneurysm diagnosed 24 years following a gunshot wound. The patient, a 71-year-old male, came to medical attention due to a palpable swelling and restricted movement in the left popliteal region. Notably, he had sustained a gunshot injury to the same limb over two decades earlier, during which no immediate vascular complications were identified. Diagnostic imaging played a crucial role in this case. Doppler ultrasonography and computed tomography (CT) angiography revealed a large pseudoaneurysm measuring 12 centimetres in diameter, accompanied by erosion of the adjacent tibial bone. Surgical exploration confirmed the diagnosis of a popliteal artery pseudoaneurysm. The patient underwent successful vascular reconstruction using an autologous saphenous vein graft, which restored arterial continuity and limb function. This case highlights the diagnostic challenges posed by late-presenting popliteal artery pseudoaneurysms. Because symptoms can remain latent for years, these vascular abnormalities may be overlooked or misdiagnosed, particularly when there is a long interval since the initial trauma. The findings underscore the importance of prolonged and vigilant follow-up in patients who have sustained penetrating limb injuries, as pseudoaneurysms can develop decades later. Early diagnosis, facilitated by appropriate imaging modalities such as Doppler ultrasound and CT angiography, is essential for effective management. Prompt surgical intervention can prevent serious complications, including rupture, limb ischemia, or chronic pain, ultimately improving patient outcomes.

Keywords: Popliteal artery pseudoaneurysm, Delayed vascular complication, Gunshot wound sequelae, Saphenous vein graft, Chronic traumatic aneurysm

Sorumlu Yazar: tuna demirk�ran, T�rkiye
Makale Dili: �ngilizce

ATIF KOPYALA

At�f dosyas� indir RIS EndNote BibTex Medlars Procite Reference Manager Yazara e-posta g�nder Benzer makaleler PubMed Google Scholar