Pseudoaneurysm in a pediatric patient with hemophilia: a case report
DOI:
https://doi.org/10.35954/SM2026.45.1.8.e502Keywords:
Aneurysm, false, follow-up studies, factor VIII, hemophilia A, wounds and injuries, hand, pediatricsAbstract
Introduction: A pseudoaneurysm is a vascular complication resulting from arterial injury. Its occurrence in the digital arteries of the hand is rare, especially in pediatric patients. In patients with hemophilia, diagnosis may be delayed, as persistent bleeding is often attributed to the underlying coagulopathy. Clinical suspicion and the timely use of imaging studies are essential for diagnosis and treatment.
Case report: We present the case of a pediatric patient with a history of hemophilia A who presented with a mass and recurrent bleeding episodes in the palm of the right hand, one month after a puncture injury. The diagnosis of pseudoaneurysm was made via computed tomography angiography. The patient was treated surgically with resection of the pseudoaneurysm and ligation of the vascular ends, combined with perioperative factor VIII replacement.
Results: The postoperative course was favorable, with no immediate complications or recurrence of bleeding. The patient demonstrated adequate wound healing and functional recovery of the hand, with no clinical signs of recurrence during follow-up.
Discussion: In patients with hemophilia, diagnosing pseudoaneurysms can be more challenging due to the condition’s characteristic tendency toward persistent bleeding. When faced with a wound exhibiting recurrent bleeding that does not respond to appropriate hematologic management, the possibility of an underlying vascular lesion should be considered. Imaging studies, such as CT angiography, allow for confirmation of the diagnosis and planning of surgical treatment.
Conclusions: Digital artery pseudoaneurysm is a rare but potentially underdiagnosed complication in patients with hemophilia. Maintaining a high index of suspicion and performing imaging studies early allows for timely diagnosis and appropriate surgical treatment, thereby preventing complications and recurrences.
NOTE: This article has been approved by the Editorial Committee.
Received for review: January 2026.
Accepted for publication: February 2026.
Publication date: April 2026.
Correspondence: Pereira Rossell Hospital Center. 1590 Artigas Boulevard. Zip Code 11600. Tel.: (+598) 2708 77 41–44. Montevideo, Uruguay.
Contact email: victoria.hernandezsosa@gmail.com
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Copyright (c) 2026 : Victoria Hernández Sosa, Lucía d´'Oliveira y Pablo Rodríguez.
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