Occlusion of acute distal brachial, proximal radial and ulnar arteries in a young thrower

Acute arterial occlusion, a rare condition in throwers, requires early detection and treatment for avoiding further complications. Thus far, no study has mentioned the occurrence of distal brachial, proximal radial, and ulnar artery occlusion in baseball players. An adolescent baseball pitcher presented with acute occlusion of the distal brachial, proximal radial, or ulnar artery. The patient complained of a cold sensation in the hand, wrist, and distal forearm. On physical examination, decreased surface skin temperature, and no radial pulse in the wrist suggested arterial occlusion. Emergency angiography validated the clinical suspicion, and identified the arteries and sites of vascular occlusion. Surgery was performed to alleviate the occlusions, thereby resolving the preoperative complaints and abnormal findings. Furthermore, postoperative magnetic resonance imaging of the shoulder and elbow joint was conducted to determine the causes of arterial occlusion. The patient resumed pitching 4 months postoperatively, and has remained active and symptom free. Magnetic resonance imaging examination revealed no vascular abnormalities or bony or soft tissue in the shoulder or elbow region. With early detection and treatment, a favorable prognosis can be achieved in baseball pitchers with acute upper extremity arterial occlusion so that their pitching career is not jeopardized. Copyright (C) 2016, Taiwan Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.