Pseudoaneurysm - Diagnosis

Diagnosis

The diagnosis should be suspected if the patient has a history of arterial trauma. This can include arterial access for catheterization (i.e. the common femoral artery), blunt trauma (i.e. to an extremity), or penetrating trauma (i.e. gunshot or blast injury). Blunt or penetrating trauma can cause a disruption in the arterial wall, leading to a pseudoaneurysm. A patient with such a history who presents with a painful, pulsatile, tender mass at the site of catheterization or trauma should be suspected to have a pseudoaneurysm. The diagnosis should be confirmed using Duplex ultrasonography, which will reveal arterial blood flow into the pseudoaneurysm. A CT angiogram or conventional angiogram can also diagnose a pseudoaneurysm.

It is important that the diagnosis be confirmed before any procedures are performed. Incision and drainage of a suspected abscess, which instead is a pseudoaneurysm, could lead to extensive hemorrhage.