AN OFTEN MISSED ETIOLOGY FOR UNILATERAL PAINFUL SWOLLEN LEG

Abstract

In unilateral leg swelling, we often think of venous or lymphatic disease and rarely think about arterial disease. The latter group, though uncommon, remains an important and easily missed cause, especially in long standing cases. Arteriovenous fistula (AVF) is one such entity. It is an abnormal communication between an artery and a vein, resulting from trauma (especially penetrating), surgery or iatrogenic causes. Fistulas are seen most commonly in the neck and that too involving common carotid artery and internal jugular vein.1 In the lower limbs, they may remain un- or misdiagnosed for long periods and in the mean time produce disability. We present one such case which was diagnosed late in the course of disease.