Ruptured femoral artery pseudoaneurysm revealed by necrotizing fasciitis complicated with lower limb acute ischemia

Mokhtari, S. Ahmad; BESANCENOT, Aurélien; BESANCENOT, Jacques; LEROUX, François

doi:10.1016/j.avsurg.2022.100061

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…The common femoral artery is the most reported localization in literature 4 . The usual clinical presentation of uncomplicated cases is a pulsatile tender mass associated with crepitus and general septic syndrome 5 . Swelling from a large pseudoaneurysm, or hematoma may potentially cause nerve and vascular compression with accompanying neuropathy, venous thrombosis, claudication, or, in rare cases, catastrophic limb ischemia 6 .…”

Section: Discussion and Take‐home Messagementioning

confidence: 99%

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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Section: Discussion and Take‐home Messagementioning

confidence: 99%

Infected femoral artery pseudoaneurysm ligation and revascularisation: A case report

Alhewy,

Ghazala,

Gado

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

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“…A definitive diagnosis of necrotizing fasciitis is exploratory surgery; however, imaging and lab work can be used to differentiate necrotizing fasciitis from other infections [7]. The management of necrotizing fasciitis can be tailored to each individual case and can involve surgical debridement, aggressive antibiotic therapy, and maximal oxygenation of tissue, with or without amputation [2,8].…”

Section: Introduction and Background Introductionmentioning

confidence: 99%

Necrotizing Fasciitis Secondary to Mycotic Femoral Aneurysm: A Narrative Review of Diagnosis and Management Strategies

Elkhoury¹,

Quick²,

Kalloo³

et al. 2023

Cureus

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This comprehensive literature review aims to investigate the pathophysiology, clinical manifestations, diagnostic tools, and treatment options for necrotizing fasciitis secondary to mycotic femoral aneurysm, a rare and potentially lethal infectious disease, particularly focusing on any changes throughout the years for an update of the current literature. The pathophysiology of necrotizing fasciitis and mycotic femoral aneurysms is a complex and multifaceted process that typically involves bacterial infections as a common precursor to the onset of these conditions. This can potentially lead to the formation of an aneurysm. As the infection progresses, it can spread from the aneurysm to surrounding soft tissues, resulting in significant tissue damage, obstructed blood circulation, and ultimately culminating in cell death and necrosis. Clinical manifestations of these conditions are diverse and encompass a range of symptoms, such as fever, localized pain, inflammation, skin changes, and other indicators. It is worth noting that skin color can influence the presentation of these conditions, and in patients with diverse skin tones, certain symptoms may be less noticeable due to a lack of visible discoloration. Imaging, laboratory findings, and clinical presentation are important components of the diagnosis of mycotic aneurysms. CT scans are a reliable tool for identifying specific features of infected femoral aneurysms, and elevated inflammatory laboratory results can also suggest a mycotic aneurysm. In the case of necrotizing fasciitis, clinicians should maintain a high level of suspicion as this condition is rare but life-threatening. Clinicians will need to view the big picture when an infection may be caused by necrotizing fasciitis, considering CT imaging, blood work, and clinical presentation of the patient without delaying surgical intervention. By incorporating the diagnostic tools and treatment options outlined in this review, healthcare professionals can improve patient outcomes and reduce the burden of this rare and potentially lethal infectious disease.

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Ruptured femoral artery pseudoaneurysm revealed by necrotizing fasciitis complicated with lower limb acute ischemia

Cited by 2 publications

References 9 publications

Infected femoral artery pseudoaneurysm ligation and revascularisation: A case report

Infected femoral artery pseudoaneurysm ligation and revascularisation: A case report

Necrotizing Fasciitis Secondary to Mycotic Femoral Aneurysm: A Narrative Review of Diagnosis and Management Strategies

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