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[Interest and feasibility of local anesthesia in the management of massive extravasation of contrast medium].

Abstract
Radiographic contrast medium extravasation in the upper extremity is not rare. It can be responsible for functional (compartment syndrome) and cosmetic sequelae. It is very difficult to predict the degree of final tissue injury in emergency. Currently, there is no consensus of emergency treatment. However, liposuction and saline washout as described by Gault is the usual treatment. We report the case of 42 year-old woman with radiographic contrast medium extravasation in the arm (120 cm(3)) with neurologic complications involving median nerve and medial cutaneous nerves of arm and forearm. Emergency conservative surgical washout with saline solution was performed under local anaesthesia. Drainage was realised by lipoaspiration cannula and arm massages. Clinical and radiological results were estimated. Ultimately, the patient has retained no sequela. Contrast medium extravasation in the arm with tissue complications is exceptional. We think that saline washout and lipoaspiration cannula drainage are an emergency useful treatment for radiographic contrast medium extravasation with tissue complications. Tolerance of the management was quite good. Postoperative X-rays are useful to assess treatment efficacy.
AuthorsC Ho Quoc, B Chaput, J-L Grolleau
JournalChirurgie de la main (Chir Main) Vol. 32 Issue 2 Pg. 108-12 (Apr 2013) ISSN: 1769-6666 [Electronic] France
Vernacular TitleIntérêts et faisabilité de l'anesthésie locale dans la prise en charge de l'extravasation massive de produit de contraste.
PMID23538101 (Publication Type: Case Reports, English Abstract, Journal Article)
CopyrightCopyright © 2013 Elsevier Masson SAS. All rights reserved.
Chemical References
  • Contrast Media
  • Saline Solution, Hypertonic
Topics
  • Adult
  • Anesthesia, Local
  • Contrast Media (adverse effects)
  • Drainage (methods)
  • Extravasation of Diagnostic and Therapeutic Materials (therapy)
  • Female
  • Humans
  • Massage
  • Saline Solution, Hypertonic (administration & dosage)
  • Suction
  • Therapeutic Irrigation
  • Upper Extremity

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