Case presentation A 65-year-old previously healthy male presented to the general medical ward with mild pain following multiple wasp stings over his head and upper trunk. He was initially hemodynamically stable but developed angioedema of the lips and tongue, requiring intramuscular adrenaline. Approximately eight hours after the incident, he experienced severe pain in his left upper limb. Examination The left upper limb was cold to touch.
Feeble radial and brachial pulses in the affected limb Finger pulse oximetry failed to detect oxygen saturation Initial treatment Urgent vascular surgical consultation was obtained. Intravenous heparin infusion was initiated. CT angiogram (Cover image A) Thrombosis of a long segment of the brachial artery from the mid-humerus level on the left side Surgical interventions Thrombectomy was performed the same day. A fasciotomy was carried out the next…
