Abstract
Background: This is the first report on an accidental arteriovenous fistula of the upper limb. We discuss in this publication the clinical presentation, diagnostic process and treatment options of arteriovenous fistula (AVF) that can be conservative and interventional. Case presentation: We are reporting a case of a 89-year old white man with a necrotic fingertip ischemia secondary to a traumatic AVF. A Doppler sonography showed an AVF between the metacarpal bones of the digits 1 and 2 and confirmed a hand and forearm vein dilation. A fistula ligation would be indicated as first-line therapy, which was rejected by the elderly multimorbid patient. Owning to risk of potential wound healing problems, lifetime medical management such as manicure of the right index is recommended. In case of injury, compression therapy should be performed. The follow up was without complication. Conclusion: A fistula ligation is the therapy of choice in a patient with an arteriovenous fistula of the upper limb.
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