Hemorrhage of AV fistula: Difference between revisions
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==Background== | ==Background== | ||
*Potentially life-threatening | |||
*Can result from aneurysms, anastomosis rupture, or over-anticoagulation | |||
===Types=== | |||
*Aneursym (true) | |||
**Most are asymptomatic; rarely rupture | |||
*Pseudoaneurysm | |||
**Results from subcutaneous extravasation of blood from puncture sites | |||
**Bleeding from puncture site is usually controlled by digital pressure or subq suture | |||
**Consider vascular surgery consultation for continued bleeding or infection | |||
**Arterial Doppler US studies can identify the aneurysm or pseudoaneurysm | |||
==Clinical Features== | ==Clinical Features== | ||
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==Workup== | ==Workup== | ||
*Consider Doppler US | |||
==Management== | ==Management== | ||
*Control bleeding w/ pressure applied to puncture site for 5-10min; observe for 1-2hr | |||
==Disposition== | ==Disposition== | ||
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==Sources== | ==Sources== | ||
<references/> | <references/> | ||
Revision as of 06:20, 12 December 2014
Background
- Potentially life-threatening
- Can result from aneurysms, anastomosis rupture, or over-anticoagulation
Types
- Aneursym (true)
- Most are asymptomatic; rarely rupture
- Pseudoaneurysm
- Results from subcutaneous extravasation of blood from puncture sites
- Bleeding from puncture site is usually controlled by digital pressure or subq suture
- Consider vascular surgery consultation for continued bleeding or infection
- Arterial Doppler US studies can identify the aneurysm or pseudoaneurysm
Clinical Features
Differential Diagnosis
AV Fistula Complications
- Clotting of AV fistula
- Infection of AV fistula
- Hemorrhage of AV fistula
- Vascular insufficiency from AV fistula
- AV fistula aneurysm/pseudoaneurysm
- High-output heart failure from AV fistula
Workup
- Consider Doppler US
Management
- Control bleeding w/ pressure applied to puncture site for 5-10min; observe for 1-2hr