Acute limb ischemia due to diclofenac sodium iatrogenic intra-arterial injection: a case report

Abstract

We report the case of accidental intra-arterial injection of diclofenac sodium in the brachial artery leading to acute limb ischemia. Iatrogenic intra-arterial injection is rarely reported in the literature; however, it is toxic and can lead to limb amputation. Only two cases of intra-arterial injection of diclofenac have been reported in the literature. The proposed pathophysiological mechanism is vasospasm, intravascular thrombosis, and chemical endoarteritis. The most common anatomical location in accidental intra-arterial injection is the antecubital fossa, where branches of the ulnar and brachial arteries are more superficial. The injection of medication must be as careful as possible, since the intra-arterial injection can affect the functional prognosis of the organ.