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CASE #1: An Interesting case of Venous Malformation

An Interesting case of Venous Malformation

A 39 year old lady, labourer came with swelling in the right distal forearm since 12 years which wasPicture1 gradually increasing in size and pain at the site since 6 months . There was no history of bleeding/trauma.

On Physical Examination there was full strength in all limbs and normal tone. Sensation was intact. Reflexes were normal throughout and there were no pathological reflexes.

On local examination there was 7 x 6 cm firm swelling in radial aspect of right forearm which was  non- pulsatile ,non compressible and there was no bruit.The distal pulses were well felt.Picture2

MRI right upper arm plain showed RIGHT FRONTAL LOW FLOW AVM. No dilation of the right radial artery and vein seen. No hemorrhage seen

Management-In this patient we decided to surgically excise the swelling as the swelling was large and the patient had previously tried to manage conservatively by going in for native medication which caused a scar hence requested for surgical excision.

Through a longitudinal incision the venous malformation measuring 4X3cms with phleboliths attached to extensor carpi radialis and underlying tendons in the right distal forearm was excised and a drain was fixed and secured.

The drain was removed on the 3rd post operative day. The patient is currently doing well with no recurring swelling or pain.