Pseudoaneurysm and arteriovenous fistula of the brachial artery presenting 25 years after elbow fracture: a case report

Post-traumatic pseudoaneurysms (PSAs) are uncommon vascular complications resulting from partial disruption of the arterial wall, leading to a contained hematoma that maintains communication with the arterial lumen. Although most PSAs develop shortly after trauma or vascular intervention, markedly delayed presentations are exceedingly rare and may pose significant diagnostic and therapeutic challenges. When associated with arteriovenous fistula (AVF) formation, these lesions carry an increased risk of progressive enlargement and sudden hemorrhage.

We report a 37-year-old male who presented with intermittent bleeding, pain, and swelling in the left upper extremity, 25 years after sustaining a simple elbow fracture treated conservatively during childhood. Physical examination revealed a firm, tender, expansile pulsatile mass over the posterior aspect of the left elbow