Infected femoral pseudoaneurysms in intravenous drug abusers: a decade of experience from a Singapore tertiary centre

Samarakoon, Lasitha; Ho, Derek Chun Yin; Tan, Yih Kai; Kum, Steven; Lim, Darryl

doi:10.11622/smedj.2020011

Cited by 12 publications

(19 citation statements)

References 22 publications

(19 reference statements)

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“…The most common complications resulting from such behavior include cellulitis, abscess formation, soft tissue necrotizing infection, deep vein thrombosis, infected thrombi, arteriovenous fistulae and pseudoaneurysm formation [5]. When aseptic techniques are not applied, infection can lead to necrotizing fasciitis in the groin [3]. Repeated needle pricks can lead to periarterial extravasation and formation of a hematoma, which in turn can become infected and erode the vessel wall leading to a pseudoaneurysm formation [3].…”

Section: Discussionmentioning

confidence: 99%

“…When aseptic techniques are not applied, infection can lead to necrotizing fasciitis in the groin [3]. Repeated needle pricks can lead to periarterial extravasation and formation of a hematoma, which in turn can become infected and erode the vessel wall leading to a pseudoaneurysm formation [3]. Infected pseudoaneurysms in IVDA most commonly involve the femoral artery [3].…”

Section: Discussionmentioning

confidence: 99%

“…Repeated needle pricks can lead to periarterial extravasation and formation of a hematoma, which in turn can become infected and erode the vessel wall leading to a pseudoaneurysm formation [3]. Infected pseudoaneurysms in IVDA most commonly involve the femoral artery [3]. A wide differential exists when having an IVDA patient with groin pain and fever [3].…”

Section: Discussionmentioning

confidence: 99%

“…Infected pseudoaneurysms in IVDA most commonly involve the femoral artery [3]. A wide differential exists when having an IVDA patient with groin pain and fever [3]. Groin pain, a pulsatile mass, femoral erythematous scarring, or fever in an IVDA patient should raise suspicion for a femoral artery aneurysmal infection.…”

Section: Discussionmentioning

confidence: 99%

“…It usually presents with groin pain, scarring, and the presence of a pulsatile mass. A thorough history, precise physical exam and imaging by computed tomography (CT) scan with contrast and Doppler ultrasound are all crucial for diagnosis [3]. NF is challenging for vascular surgeons in terms of diagnosis and management (debridement alone +/revascularization).…”

Section: Introductionmentioning

confidence: 99%

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Necrotizing Fasciitis Causing Complete Femoral Vessels Necrosis and Thrombosis in an Intravenous Drug Abuser: A Case Report

et al. 2021

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Background: Intravenous drug abuse is an anciently known health and social problem worldwide. The nonsterile application of addicting drugs leads to severe life-threatening vascular complications. The femoral triangle is an easy target for this purpose. Groin necrotic fasciitis (NF) with vessel necrosis is a challenging diagnosis that requires prompt treatment. Case Report: A 44-year-old male intravenous drug user presented for a left groin pain. He was diagnosed by computed tomography scan to have necrotizing fasciitis. Urgent debridement was performed and identified infected and necrotic ruptured femoral vessels without active bleeding. Debridement with vessel ligation was performed, and delayed revascularization was planned. The patient was admitted six weeks later with a left fifth toe necrosis and delayed arterial revascularization was performed via extra-anatomic trans-obturator ilio-femoral anastomosis. The patient had a favorable follow-up. Conclusion: NF in intravenous drug abusers should always be taken into consideration when a patient presents with groin pain and swelling. Urgent surgical control should be established. Extra-anatomical trans-obturator ilio-femoral anastomosis is a good option for revascularization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Necrotizing Fasciitis Causing Complete Femoral Vessels Necrosis and Thrombosis in an Intravenous Drug Abuser: A Case Report

et al. 2021

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Infected femoral artery pseudoaneurysm ligation and revascularisation: A case report

Alhewy,

Ghazala,

Gado

et al. 2024

Clinical Case Reports

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Key Clinical MessageAlthough ligating femoral pseudoaneurysm is a safe procedure, some cases require revascularization, and the appropriate treatment should be tailored to the patient.AbstractIn this case report, we highlight the challenge in treating infected femoral artery pseudoaneurysm. The patient, a 37‐year‐old male intravenous drug abuser, presented to the emergency department with a 2‐month history of a progressively growing lump over his right groin. Two days before the presentation the swelling became hot and painful. After physical examination, it was revealed that the localized swelling is about 15 × 15 cm in size. It is pulsating, expanding in all directions, moving from side to side, and has been reduced in size due to proximal artery compression with the inflamed overlying skin causing slight flexion of the right hip joint and there was serosanguineous discharge as well. The affected leg was warm with intact motor and sensory function, palpable femoral, and popliteal arterial pulses, but non‐palpable left posterior tibial and anterior tibial arterial pulses, both of which had triphasic wave signals on a portable hand‐held Doppler (there was below knee marked edema). CT angiography (CTA) revealed a large well‐defined heterogeneous cystic structure at the right groin with an average diameter of 11 × 10 × 9 cm, with a connection with the common femoral artery. After proximal and distal control, excision of the infected femoral pseudoaneurysm, a swab was taken, and ligation of the common femoral artery superficial femoral artery, and profunda femoral artery. No signals were detected on the posterior or anterior tibial arteries by hand‐held Doppler and oxygen saturation on the big toe was markedly decreased, so we did an extra‐anatomic lateral ilio‐femoral anastomosis using silver‐impregnated vascular graft.

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3D Cinematic rendering for evaluating femoral pseudoaneurysms in injection drug users

Yasrab,

Rizk,

Chu

et al. 2024

Emerg Radiol

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Infected femoral pseudoaneurysms in intravenous drug abusers: a decade of experience from a Singapore tertiary centre

Cited by 12 publications

References 22 publications

Necrotizing Fasciitis Causing Complete Femoral Vessels Necrosis and Thrombosis in an Intravenous Drug Abuser: A Case Report

Necrotizing Fasciitis Causing Complete Femoral Vessels Necrosis and Thrombosis in an Intravenous Drug Abuser: A Case Report

Infected femoral artery pseudoaneurysm ligation and revascularisation: A case report

3D Cinematic rendering for evaluating femoral pseudoaneurysms in injection drug users

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