Contrast Extravasation into the Right Upper Extremity
KEY WORDScontrast extravasation hyaluronidase
Contrast extravasation occurs in < 1 % of CT scans.1 , 2 Most cases involve small volumes, and feature self-limited pain and swelling,1 but extravasation rarely leads to skin blistering, tissue necrosis or compartment syndrome.3 , 4 Management involves prompt cessation of the infusion, extremity elevation and application of compresses.5 In cases with neurovascular compromise, immediate surgical decompression is recommended.3 For large volume extravasations, localized subcutaneous hyaluronidase injections can be considered, which hydrolyze glycosaminoglycans in the extracellular matrix of connective tissue, transiently increasing the permeability of the tissue. The increased permeability allows for the diffusion of extravasated materials back into the vascular bed, thereby alleviating compartment pressure.5
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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