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Delayed Surgical Management of a Post-Traumatic Radio-Cephalic Arteriovenous Fistula Presenting 27 Years after Penetrating Injury: A Case Report
Category: Case Reports
Published: October 2026
Issue: Vol. 4, Issue 2
Pages: 287 - 292
Authors
Ikenna Ezirike
Federal Teaching Hospital Owerri
ikennaezirike01@gmail.com
Abstract

Vascular injuries, although uncommon as they account for 4% of trauma-related injuries, are a major cause of morbidity and mortality. The risk of morbidity and mortality however increases with delayed presentation, diagnosis and treatment. This is depicted in the exceptionally delayed presentation of a post-traumatic radiocephalic arteriovenous fistula occurring 27 years after penetrating upper limb trauma, accompanied by marked aneurysmal vascular remodelling and tortuosity. The report therefore tries to highlight the role of open surgical repair in resource-limited settings where endovascular management may be technically unsuitable due to the complexity of the vascular anatomy.
CASE REPORT
A 56-year-old male presented with complaints of a gradual onset, progressive, pulsatile, painless, and noncompressible swelling on the left elbow region which worsened to involve the upper two-thirds of his arm and lower one-third of his forearm over a 27-year period. The lesion developed following a stab injury to the anterior aspect of his left elbow. A CT angiogram done thereafter showed a left radio-cephalic arteriovenous fistula located 0.5 cm distal to the left elbow joint. He eventually had a fistula takedown using a trans-venous repair technique with good distal radial pulses postoperatively. There were no repair complications until his eventual discharge on postoperative day 10.
CONCLUSION
Traumatic arteriovenous fistula, although an uncommon complication of trauma injuries, may result in lifethreatening consequences especially when diagnosis and treatment is delayed. Early recognition and appropriate imaging is essential for treatment planning while open surgical repair remains a valuable therapeutic option in anatomically complex lesions and resource-constrained settings.

Keywords:
Surgical treatment, post-traumatic, radiocephalic arteriovenous fistula
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How to Cite This Article
Ikenna Ezirike. (October 2026). Delayed Surgical Management of a Post-Traumatic Radio-Cephalic Arteriovenous Fistula Presenting 27 Years after Penetrating Injury: A Case Report. Eastern Heartland Journal of Medicine, Volume 4, Issue 2, pp. 287-292.
Article Information

Submitted: May 7, 2026

Published: October 17, 2026

Pages: 287 - 292

Journal: Eastern Heartland Journal of Medicine

Publisher: Federal Teaching Hospital Owerri, Nigeria

ISSN: 2734-2875 (Print)