Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2013 Feb;48(1):27-32. Korean.
    Published online Feb 26, 2013.
    https://doi.org/10.4055/jkoa.2013.48.1.27
    Copyright © 2013 by The Korean Orthopaedic Association
    Case Report

    Extravasation Injury of Forearm by Computed Tomography Contrast Medium

    Dong-Ju Shin, M.D., Young-Soo Byun, M.D., and 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, Email: aabga@hanmail.net
    Received June 22, 2012; Revised August 02, 2012; Accepted August 06, 2012.

    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

    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.

    Tables

    Table 1
    Details of Authors Cases of References

    References

      1. Cohan RH, Ellis JH, Garner WL. Extravasation of radiographic contrast material: recognition, prevention, and treatment. Radiology 1996;200:593–604.
      1. 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.
      1. Loth TS, Jones DE. Extravasations of radiographic contrast material in the upper extremity. J Hand Surg Am 1988;13:395–398.
      1. 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.
      1. 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.
      1. 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.
      1. Sistrom CL, Gay SB, Peffley L. Extravasation of iopamidol and iohexol during contrast-enhanced CT: report of 28 cases. Radiology 1991;180:707–710.
      1. 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.
      1. 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.
      1. Vandeweyer E, Heymans O, Deraemaecker R. Extravasation injuries and emergency suction as treatment. Plast Reconstr Surg 2000;105:109–110.
    Cited by
    Crossref 1
    Google Scholar 
    MeSH Terms
    Compartment Syndromes
    Contrast Media
    Extravasation of Diagnostic and Therapeutic Materials
    Forearm
    Necrosis
    Skin
    Metrics
    Share
    Figures
    slide
    slide
    slide

    1 / 3

    Tables
    slide

    1 / 1

    PERMALINK