Extravasation Injury of Forearm by Computed Tomography Contrast Medium

Dong-Ju Shin; Young-Soo Byun; Sung Choi

doi:10.4055/jkoa.2013.48.1.27

Journal List > J Korean Orthop Assoc > v.48(1) > 1013237

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin, Byun, and Choi: Extravasation Injury of Forearm by Computed Tomography Contrast Medium

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(1): 27-32.

Published online: 26 February 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.1.27

Extravasation Injury of Forearm by Computed Tomography Contrast Medium

Dong-Ju Shin, M.D., Young-Soo Byun, M.D., Sung Choi, M.D.

Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea.

Correspondence to: Young-Soo Byun, M.D. Department of Orthopedic Surgery, Daegu Fatima Hospital, 99, Ayang-ro, Dong-gu, Daegu 701-724, Korea. TEL: +82-53-940-7324, FAX: +82-53-954-7414, aabga@hanmail.net

Received 22 June 2012 Revised 2 August 2012 Accepted 6 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In recent years, there has been a noticeable increase in contrast media extravasation injury. However, definite guidelines for the treatment of the injury have not yet been established, although it causes severe complications such as compartment syndrome, skin necrosis etc. We try to introduce conservative management with a thorough review of the relevant literatures about successful treatment and functional restoration from contrast media extravasation injury without any complications.

Keywords: contrast media, extravasation, treatment

Figures and Tables

Figure 1

Clinical appearance of the upper extremity shows (A) tissue tension, global swelling, and blisters in the volar region 5 hours after the injury, and (B) radiographs of forearm and humerus 2 hours after the injury show a considerable extension of extravascular contrast.

Figure 2

Clinical appearance of the upper extremity shows (A) the improvement of swelling without additional bullae formation, and (B) radiographs of the forearm and humerus show nearly contrast-absorption, except for some proximal brachium portion, 2 days after the injury.

Figure 3

Clinical appearance of the upper extremity shows (A) complete remission of externals without any complications, and (B) radiographs of the forearm and humerus show no extra remaining contrast 3 months after the injury.

Table 1

Details of Authors Cases of References

Classifiying the sort of contrast, the use of infusion pump, the amount of extravascular contrast and its treatment. We have known that almost conservative therapy gets better results at using the latest nonionic, hyposmotic contrast, in comparison with ionic, hyperosmotic contrast. Osm, osmorality.

References

1. Cohan RH, Ellis JH, Garner WL. Extravasation of radiographic contrast material: recognition, prevention, and treatment. Radiology. 1996. 200:593–604.

2. Federle MP, Chang PJ, Confer S, Ozgun B. Frequency and effects of extravasation of ionic and nonionic CT contrast media during rapid bolus injection. Radiology. 1998. 206:637–640.

3. Loth TS, Jones DE. Extravasations of radiographic contrast material in the upper extremity. J Hand Surg Am. 1988. 13:395–398.

4. Sbitany H, Koltz PF, Mays C, Girotto JA, Langstein HN. CT contrast extravasation in the upper extremity: strategies for management. Int J Surg. 2010. 8:384–386.

5. Schaverien MV, Evison D, McCulley SJ. Management of large volume CT contrast medium extravasation injury: technical refinement and literature review. J Plast Reconstr Aesthet Surg. 2008. 61:562–565.

6. Wang CL, Cohan RH, Ellis JH, Adusumilli S, Dunnick NR. Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69,657 intravenous injections. Radiology. 2007. 243:80–87.

7. Sistrom CL, Gay SB, Peffley L. Extravasation of iopamidol and iohexol during contrast-enhanced CT: report of 28 cases. Radiology. 1991. 180:707–710.

8. Bellin MF, Jakobsen JA, Tomassin I, et al. Contrast Media Safety Committee of the European Society of Urogenital Radiology. Contrast medium extravasation injury: guidelines for prevention and management. Eur Radiol. 2002. 12:2807–2812.

9. Belzunegui T, Louis CJ, Torrededia L, Oteiza J. Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report. Scand J Trauma Resusc Emerg Med. 2011. 19:9.

10. Vandeweyer E, Heymans O, Deraemaecker R. Extravasation injuries and emergency suction as treatment. Plast Reconstr Surg. 2000. 105:109–110.

TOOLS

Similar articles