D�rt ya��ndaki �ocuk hastada k�pek �s�r��� sonras� g�r�len s�perfisiyal temporal arter ps�doanevrizmas�: Literat�rdeki ilk vaka

I��ktekin, Emrah

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H�zl� Arama

D�rt ya��ndaki �ocuk hastada k�pek �s�r�� sonras� g�r�len s�perfisiyal temporal arter ps�doanevrizmas�: Literat�rdeki ilk vaka [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2025; 31(5): 486-489 | DOI: 10.14744/tjtes.2025.94797

D�rt ya��ndaki �ocuk hastada k�pek �s�r�� sonras� g�r�len s�perfisiyal temporal arter ps�doanevrizmas�: Literat�rdeki ilk vaka

Emrah I��ktekin
Bal�kesir �niversitesi T�p Fak�ltesi, Plastik Rekonstr�ktif ve Estetik Cerrahi Ana Bilim Dal�, Bal�kesir-Türkiye

Ekstrakraniyal arteriyel sistemin ps�doanevrizmalar� nadirdir. Bunun nedeni, y�zeysel damarlar�n boyutlar�n�n ince ve �aplar�n�n k��k olmas�d�r. Bu yaz�da, �� ay �nceki k�pek �s�rmas� sonras�nda 4 ya��ndaki bir �ocukta y�zeysel temporal arterde olu�an ps�doanevrizma ve klini�i sunuldu. Acil servise ba�vuran hastan�n lezyonu ilk olarak muhtemelen bir yabanc� cisim ile abse olu�umu olarak d��n�lm�� ve drene edilmeye �al��lm��t�r. �nsizyon sonras� lezyonun abse olmad��, aktif kanama ve tromb�slerin fark edilmesi �zerine plastik, rekonstr�ktif ve estetik cerrahi klini�i�ne y�nlendirilmi�tir. Yap�lan fizik muayenede sol frontotemporal b�lgede, ka� �st�nde, 21x18x12 milimetre boyutlar�nda ele gelen kitle tespit edildi. Lokal enflamatuvar belirtiler veya fluktasyon saptanmad�. �st y�z mimikleri ve ka� hareketleri normaldi. Laboratuvar testleri normal sonu�lar verdi. Doppler ultrasonografide "yin ve yang i�areti" ad� verilen, girdap �eklinde belirgin bir ps�doanevrizma ile birlikte k�smi tromboz saptand�. Hasta, s�z�nt� �eklinde aktif kanamas� olmas� nedeniyle acil ameliyata al�nd� ve y�zeysel temporal arterin �n dal�, debridman ve kan p�ht�lar�n�n uzakla�t�r�lmas�ndan sonra ps�doanevrizma boynuna kadar disseke edildi. Lezyonun, ka�a kadar olan derin k�sm�nda yakla��k 1 cm �ap�nda ps�doanevrizma g�r�ld� ve arter, segmental kilitli s�t�r ile anevrizma her iki ucundan ba�lanarak eksize edildi. Ameliyat sonras� hasta, komplikasyonsuz olarak klinikte izlendi ve taburcu edildi. Patolojik analizde, t�m�r duvar�n�n organizasyonlu kar��k tromb�sten olu�tu�u g�r�ld�. Hastan�n takipleri s�ras�nda herhangi bir komplikasyon geli�medi. Sunulan vakada da g�r�ld�� zere, travmatik patolojilerin g�zden ka��r�lmamas� i�in detayl� bir anamnez al�nmas�, titiz bir klinik muayene yap�lmas� ve ultrason d�hil detayl� g�r�nt�leme �al��malar�n�n yap�lmas� b�y�k �nem ta��maktad�r. Bu t�r �nlemler, bu gibi nadir vakalarda altta yatan t�bbi durumlar�n erken tespiti ve y�netimini sa�lamak, b�ylece daha fazla komplikasyonu �nlemek ve prognozu iyile�tirmek i�in gereklidir.

Anahtar Kelimeler: K�pek �s�r�� travmas�, ps�doanevrizma, superfisial temporal arter.

A superficial temporal artery pseudoaneurysm following dog bites in a 4-year-old child: The first case reported in the literature

Emrah I��ktekin
Department of Plastic, Reconstructive and Aesthetic Surgery, Bal�kesir University Faculty of Medicine, Bal�kesir-Türkiye

Pseudoaneurysms of the extracranial arterial system are rare, largely due to the small size and thin walls of superficial vessels. This report presents a case of a pseudoaneurysm of the superficial temporal artery (STA) following dog bites in a 4-year-old child, an injury sustained three months prior. The lesion was initially misdiagnosed as an abscess, possibly involving an occult foreign body, and was unsuccessfully drained in the Emergency Department (ED). Physical examination revealed a palpable mass measuring 21 � 18 � 12 mm in the left frontotemporal region above the eyebrow. There were no signs of local inflammation or fluctuation. The child�s facial expressions and eyebrow movements were normal, and laboratory tests were within normal limits. Doppler ultrasound demonstrated a partially thrombosed pseudoaneurysm with a well-defined swirl pattern, known as the �yin and yang� sign. The patient was admitted for surgery, and the frontal branch of the superficial temporal artery was dissected to the neck of the pseudoaneurysm after debride-ment and removal of blood clots. A pseudoaneurysm measuring approximately 1 cm in diameter was observed on the deep side of the lesion, extending up to the eyebrow. The affected artery was ligated using a segmental running locking suture and then excised. Postoperatively, the patient was transferred to the clinic in stable condition without complications. Pathological analysis revealed that the tumor wall consisted of a mixed thrombus with signs of organization. The patient experienced no complications during follow-up. It is of utmost importance to obtain a comprehensive clinical history, conduct a meticulous physical examination, and perform detailed imaging studies, including ultrasound, to avoid overlooking critical pathologies in emergency situations. Such measures are essential for early detection and management of underlying medical conditions, thereby preventing further complications and improving the overall prognosis.

Keywords: Dog bite trauma, pseudoaneurysm, superficial temporal artery.

Sorumlu Yazar: Emrah I��ktekin, T�rkiye
Makale Dili: �ngilizce

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H�zl� Arama

D�rt ya��ndaki �ocuk hastada k�pek �s�r��� sonras� g�r�len s�perfisiyal temporal arter ps�doanevrizmas�: Literat�rdeki ilk vaka

A superficial temporal artery pseudoaneurysm following dog bites in a 4-year-old child: The first case reported in the literature

D�rt ya��ndaki �ocuk hastada k�pek �s�r�� sonras� g�r�len s�perfisiyal temporal arter ps�doanevrizmas�: Literat�rdeki ilk vaka