Case Report
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World J Nephrol. Aug 6, 2014; 3(3): 118-121
Published online Aug 6, 2014. doi: 10.5527/wjn.v3.i3.118
Innocuous-looking skin scab over an arteriovenous fistula: Case report and literature review
Badri Shrestha, Simon Boyes, Peter Brown
Badri Shrestha, Simon Boyes, Peter Brown, Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Sheffield S5 7AU, United Kingdom
Author contributions: Shrestha B managed the patient and prepared the manuscript; Simon Boyes was involved in preparing the manuscript; Brown P performed radiological investigations and contributed to manuscript preparation.
Correspondence to: Badri Shrestha MD FRCS FACS, Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Herries Road, Sheffield, S5 7AU, United Kingdom. shresthabm@doctors.net.uk
Telephone: +44-114-2434343 Fax: +44-114-2714604
Received: March 7, 2014
Revised: April 28, 2014
Accepted: June 10, 2014
Published online: August 6, 2014
Processing time: 226 Days and 16 Hours
Abstract

Little is written on the management of an innocuous-looking skin scab over an autogenous arteriovenous fistula (AVF) used for haemodialysis. The seriousness of the underlying pathology can be under-estimated, and this may lead to early loss of the AVF, and major-life-threatening haemorrhage. We describe the management of a 78-year-old patient presenting with an innocuous-looking scab over an AVF and review the pertinent literature on this subject.

Keywords: Arteriovenous fistula; Scab; Duplex scan; Bleeding; Treatment

Core tip: An innocuous looking scab may develop over an arteriovenous fistula after repeated punctures. There may be serious underlying damage to the arterialised vein. This case report emphasizes the importance of an early diagnostic colour Doppler examination in these circumstances and timely surgical intervention, to prevent potential life-threatening haemorrhage or other complications.