• Chunqiao Wu, Zhexia Jin, and Yongmei Yang.
• Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
• Medicine (Baltimore). 2024 Sep 6; 103 (36): e39536e39536.

RationaleLarge extremity hematoma can rarely happen after contrast extravasation during a contrast-enhanced computed tomography scan. Some hematomas need prompt surgical managements.Patient ConcernsA 77-year-old man had acute ischemic stroke and received the thrombolytic and antiplatelet therapies. He had a contrast extravasation during the computed tomography scan and developed a large hematoma in the right forearm, despite without evidence of compartment syndrome.DiagnosisRight forearm hematoma, status post contrast extravasation.InterventionsThe patient responded poorly to the routine care with arm elevation, cold pack, and wet dressing, and was finally treated by the surgical debridement, vacuum sealing drainage, fascioplasty, and skin flap repair.OutcomesRight forearm wound healed with a scar.LessonsLarge extremity hematoma can happen after contrast extravasation during computed tomography scan, which may require surgical treatments. Careful preparation, close monitor, and prompt managements should be applied in high-risk patients.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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