Late Complications of Vascular Trauma of the Extremities in Civilian Practice: A 10 Year Experience in Cameroon

Abstract Background: To describe the different presentations, diagnostic evaluations, managements and outcome of late complications of vascular trauma of the extremities (LCVTE) in civilian practice . Methodology: All the patients with LCVTE who reported at the Yaounde General Hospital from January 2010 to December 2019 were included. Patients presenting with acute vascular injuries, neck vessels injuries and iatrogenic lesions or late complications of vascular access for hemodialysis were excluded. All cases were evaluated with either ultrasound and or Computer tomography and managed with various open vascular surgical techniques and their results were assessed. Results: Fifteen patients with 17 LCVTE underwent various vascular repairs. There were 2 females and 13 males.The age range was from 8 monyhs to 54 years with a mean age of 30.28 . The time interval between injury and presentation in the hospital was 3 weeks to 15 years with a mean of 3 months. Penetrating injuries secondary to stabs were the commonest cause in 94.11%. Lower limbs vessels were affected in 12/17 (70.58%), with Superficial femoral artery being the most frequently involved artery in 6(35.29 %) cases. Sixteen (94.11%) patients presented with pseudoaneurysm, 1 with solely traumatic arteriovenous fistulae. Some pseudoaneurysms presented with complications such as infection (2 cases), bleeding (3 cases) and rupture with hypovolemic choc (1 case). The only non vascular injuries associated were were 1 brachial plexus injury and 1 fracture of the distal femur shaft For the 15 lesions who underwent surgery, the most frequent surgical techniques used were, simple suturing ( 66.66 %); followed by resection and termino-terminal anastomoses (26.66%) Unfortunately one post operative mortality was registered. After a follow-up from 6 months to 10 years no late complications was detected (No recurrence, no wound infection). Only the patient with the brachial plexus injury ended up with a flail limb that didn’t improve and the patient with femoral fracture with a shortening of the limb.Conclusion: Penetrating wounds secondary to stabs were the main injuries and pseudoaneurysm was the most common late complication. Ameliorating the management environment could reduce the morbidity.