Acute Onset of Upper Limb Ischaemia in a Young Individual Following a Trivial External Pressure: A Case Report

Background: Acute limb ischaemia (ALI) is a vascular emergency that requires immediate intervention.External trivial compression leading to ALI is extremely rare and only sparsely reported in the literature.Case description: A 36-year-old man with no history of trauma or comorbidities presented to the emergency department with sudden-onset excruciating pain in the left forearm.Clinical examination revealed a cold, cyanotic left upper limb with absent radial and brachial pulses.Bedside Doppler suggested arterial compromise, which was confirmed by computed tomography (CT) angiography demonstrating long-segment thrombosis of the brachial artery with distal propagation.Immediate anticoagulation with subcutaneous enoxaparin was initiated, followed by urgent mechanical thrombectomy within 2 hours, resulting in successful reperfusion.Thrombophilia workup revealed protein S deficiency.Conclusion: This case highlights how external compression may act as a precipitating factor in patients with underlying thrombophilia and emphasises the need for early diagnosis and timely revascularisation in preserving limb function in patients with ALI.