Ecchymosis in Surgery — 27yo Man | Vascular Surgery | SMLE Q#11582
SMLE Question #11582
Surgery
Vascular Surgery
Last updated: February 2026
A 27-year-old man is brought to the emergency department after a close-range gunshot wound to the medial left thigh. He has a large, tense, pulsatile medial-thigh hematoma with ecchymosis and a small entry wound. He reports numbness in the left foot and cannot dorsiflex or plantarflex. Dorsalis pedis and posterior tibial pulses are weaker than the right with delayed toe capillary refill. What is the most appropriate initial management?
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