Traumatic Femoral Arteriovenous Fistula Mimicking Chronic Venous Insufficiency with Concurrent Iliac and Femoral Artery Aneurysms: A Case Report

Authors

  • Tommy Kuswara Vascular Surgeon at Division of Vascular Surgery, Arifin Achmad General Hospital/Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
  • Ramzi Azrial Vascular Surgeon at Division of Vascular Surgery, Arifin Achmad General Hospital/Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
  • Tania Nugrah Utami General Surgeon Resident, Arifin Achmad General Hospital/Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia

DOI:

https://doi.org/10.37275/bsm.v9i6.1307

Keywords:

Aneurysm, Arteriovenous fistula, Chronic venous insufficiency, Gunshot wound, Traumatic

Abstract

Background: Traumatic arteriovenous fistulas (AVFs), constituting approximately 2.5% of emergency vascular cases, present diagnostic challenges due to their obscure nature. This report describes two cases of traumatic AVFs caused by gunshot wounds.

Case presentation: A 61-year-old male presented with right lower extremity pain and swelling, following a gunshot wound four months prior. Clinical findings included discoloration, edema, vein swelling, and pain from the femoral to pedis regions. CT angiography revealed multiple aneurysms from the lower abdominal aorta to the right common iliac arteries, stenosis in the right external iliac artery, and reduced blood perfusion. Additional findings were tubular aneurysms in the external and internal right iliac arteries and a combination saccular-tubular aneurysm in the right femoral artery. A second, separate case also involved a traumatic AVF from a gunshot wound.

Conclusion: Traumatic AVFs, particularly those resulting from gunshot wounds, can be difficult to diagnose early due to their rarity and obscure presentation. Early diagnosis is crucial to prevent disease progression and improve clinical outcomes. Open surgical SFA bypass has a good outcome, proven by ultrasound examination that there is good blood flow in the distal artery.

Authors

  • Tommy Kuswara1
  • Ramzi Azrial1
  • Tania Nugrah Utami2*
  1. 1Vascular Surgeon at Division of Vascular Surgery, Arifin Achmad General Hospital/Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
  2. 2General Surgeon Resident, Arifin Achmad General Hospital/Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia

Corresponding author Tania Nugrah Utami — tanianugrahutami@gmail.com

Article history

  1. Submitted
  2. Accepted
  3. Published

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Published

2025-03-25

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How to Cite

1.
Tommy Kuswara, Ramzi Azrial, Tania Nugrah Utami. Traumatic Femoral Arteriovenous Fistula Mimicking Chronic Venous Insufficiency with Concurrent Iliac and Femoral Artery Aneurysms: A Case Report. Bioscmed [Internet]. 2025 Mar. 25 [cited 2026 Aug. 12];9(6):1878-89. Available from: https://bioscmed.com/index.php/bsm/article/view/1307