Abstract
Unusual Presentation of Axillary Artery Injury
Highlights
Intra-arterial drug injection is a rare emergency but can occur accidentally by IV drug abusers or iatrogenically in some patients [1]
We report a case of ruptured axillary artery secondary due to selfinflicted injury by IV tramadol injection in a young tramadol addicted male which was managed successfully by exploration and repair with vein graft
On examination the affected upper limb was warm but weaker pulse compared to non-affected side
Summary
A 36 years old male tramadol addicted patient presented with swelling and pain in his right axilla. After thorough questioning the patient admitted that the swelling started two days after his selfadministered injection of tramadol, and it was causing severe pain and discomfort. He accepted that he was addicted to tramadol and had been taking injection in a similar way since along time. There was delayed capillary refill and SPO2 saturation was around 82% He had multiple scars of repeated injection on his both upper and lower limbs. The surrounding tissue near the axillary artery showed dense fibrosis and necrosis of superficial fibres of median nerve. Primary closure of the wound was achieved in both the cases without the need for distal fasciotomy
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