Managing severe iodinated contrast extravasation: a case report highlighting the role of invasive intervention

Although the incidence of contrast media extravasation (CME) is low and severe complications are rarer, when it occurs, it can lead to serious complications and patient dissatisfaction. In most cases, CME resolves with conservative treatment. However, some cases require invasive interventions for treatment. We report a case of CME in which the patient developed skin ulcers, necrosis, and hematoma after conservative treatment. Ultimately, the patient was successfully treated with manual compression, saline irrigation, and sharp debridement. Thus, a tiered strategy that combines preventive measures, vigilant clinical and imaging monitoring, proactive escalation of treatment, and transparent communication offers the best approach to minimize CME complications, accelerate recovery, and reduce the risk of medico-legal conflicts.