Use of bedside ultrasound in identification of a slowly enlarging abdominal mass as a consequence of late femorofemoral crossover bypass detachment

Abstract

IntroductionThe prevalence of intermittent claudication in people over 60 years is 6%. Femorofemoral crossover bypass represents an alternative for patients with unilateral intermittent claudication in which endovascular management is deemed unfavourable. We report diagnostic workout and treatment of an unusual late complication of Femorofemoral crossover. Case reportAn 88-year-old woman presented at the emergency department with a large, tense-elastic, nonpulsing mass in her lower abdomen. In 2002, she underwent a Femorofemoral crossover bypass for right leg claudication. In 2005, the Femorofemoral crossover bypass was complicated by the formation of a pseudoaneurysm that required surgical correction. The mass became visible 3 months before admission to the emergency department and it had slowly enlarged. An outpatient computed tomography scan, without contrast medium because of chronic renal insufficiency, was performed, showing a mass coming from the abdominal wall, not further characterizable. When the mass began to be painful, and a visible abdominal wall skin ulcer that formed began to bleed, the patient was brought to emergency department.