IMAGES IN EMERGENCY MEDICINE
Spontaneous rupture of axillary vein simulating elder physical abuse
1 Internal Medicine Unit, Hospital Comarcal do Salnés, Pontevedra, Spain
2 Radiology Unit, Hospital Comarcal do Salnés, Pontevedra, Spain
3 Surgery Unit, Hospital Comarcal do Salnés, Pontevedra, Spain
Correspondence to:
Correspondence to:
M J N Fernández
Apartado de Correos no. 192, 36080 Pontevedra, Spain; majenu@cmpont.es
| The first 150 words of the full text of this article appear below. |
An 87 year old woman presented to our emergency room with an extensive haematoma in the thoracoabdominal region (fig 1
). The patient had been well until about six days before coming to the emergency department, when she developed a swelling in the right axillary region. At the initial examination a possibility of physical abuse was raised.1,2 A nodule, 3 cm in diameter, was palpable in the right axilla. Haematologic and coagulation values were normal. A computed tomography scan of the thorax showed a nodule in the right axillary region. Colour flow Doppler revealed that the nodule was associated with the right axillary vein. This proved that our initial suspicion of physical abuse was wrong; after clinical evaluation and complementary investigations, the unusual diagnosis of spontaneous rupture of axillary vein with subcutaneous haematoma was made. This case highlights the need for exclusion of all differential diagnoses, including uncommon conditions, before
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