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Seroma as a rare complication of autologous arteriovenous fistula creation in the forearm of a hemodialysis patient: a case report

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Cita

Fig. 1.

Appearance of the left forearm: a raised mass was observed under the wound (white arrows)
Appearance of the left forearm: a raised mass was observed under the wound (white arrows)

Fig. 2.

Ultrasonographic findings on postoperative day 13 (hospital day-22): A. long-axis and B. short-axis color Doppler image showing an anechoic mass without blood flow immediately above the anastomosis. In both images, a fibrous capsule around the mass was shown (cyan arrowheads). C. long-axis image showing a ligation-induced venous stenosis 1.3 mm in diameter (yellow arrowheads). (Se: seroma, Ra; radial artery, An: anastomosis, Ce: cephalic vein)
Ultrasonographic findings on postoperative day 13 (hospital day-22): A. long-axis and B. short-axis color Doppler image showing an anechoic mass without blood flow immediately above the anastomosis. In both images, a fibrous capsule around the mass was shown (cyan arrowheads). C. long-axis image showing a ligation-induced venous stenosis 1.3 mm in diameter (yellow arrowheads). (Se: seroma, Ra; radial artery, An: anastomosis, Ce: cephalic vein)

Fig. 3.

Initial and follow-up ultrasonography: A. on postoperative day 13 (hospital day 22) and B. postoperative day 26 (hospital day 35) showing little changes in size or echogenicity. (A: 4.0 cm × 1.5 cm × 0.5 cm, B: 3.7 cm × 1.4 cm × 0.5 cm) (Se: seroma, Ce: cephalic vein)
Initial and follow-up ultrasonography: A. on postoperative day 13 (hospital day 22) and B. postoperative day 26 (hospital day 35) showing little changes in size or echogenicity. (A: 4.0 cm × 1.5 cm × 0.5 cm, B: 3.7 cm × 1.4 cm × 0.5 cm) (Se: seroma, Ce: cephalic vein)

Fig. 4.

Timeline of the clinical course
Timeline of the clinical course

Fig. 5.

Schematic illustration of the arteriovenous fistula and seroma
Schematic illustration of the arteriovenous fistula and seroma

Laboratory findings on admission

Blood cell count
WBC 3,660/μL
RBC 2.95 × 106/μL
Hb 9.2 g/dL
Ht 28.9%
PLT 9.0 × 104/μL
Blood chemistry
CRP 0.01 mg/dL
TP 5.7 g/dL
Alb 2.5 g/dL
AST 12 U/L
ALT 11 U/L
LDH 150 U/L
T-Bil 0.5 mg/dL
BUN 86.4 mg/dL
Cre 5.69 mg/dL
eGFR 5.90 mL/min
Na 142 mEq/L
K 4.3 mEq/L
Cl 109 mEq/L
Ca 8.7 mg/dL
iP 4.1 mg/dL
    HbA1c (NGSP) 5.3%
    NH3 96 µg/dL
    BNP 659 pg/mL
Coagulation
    PT-INR 1.06
    APTT 32.2 sec
    Fibrinogen 374.8 mg/dL
Infection
    HBs antibody Negative
    Anti-HBs antibody Negative
    Anti-HBc antibody Negative
    Anti-HCV antibody Positive
HCV-RNA PCR 5.9 Log IU/mL
eISSN:
2451-070X
Lingua:
Inglese
Frequenza di pubblicazione:
4 volte all'anno
Argomenti della rivista:
Medicine, Basic Medical Science, other