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Femoral pseudoaneurysm rupturing into urinary bladder: A rare presentation.

Shrestha KR, Luitel BR, Shrestha U, Shrestha UK - J Surg Case Rep (2015)

Bottom Line: Femoral pseudoaneurysm is a common occurrence in intravenous drug abuser due to repeated trauma to the femoral artery causing arterial leak contained by the surrounding tissue and does not contain all the layers of arterial wall.Rupture of these aneurysm to exterior is a common presentation while rupture into surrounding structure deemed an emergency surgical attention.Hence, we report an unusual case of rupture of femoral pseudoaneurysm into urinary bladder who presented us with history of hematuria and was successfully managed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, IOM, Kathmandu, Nepal kajanrs@gmail.com.

No MeSH data available.


Related in: MedlinePlus

Arterial Doppler pictures: (A) urinary bladder with Foley's in situ and echogenic content likely clots; (B) large solid-cystic pulsatile lesion noted in the right inguinal region; (C) lesion in connection with common femoral artery via wide neck which showed to and fro spectral wave form (classical Ying Yang flow).
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RJV045F1: Arterial Doppler pictures: (A) urinary bladder with Foley's in situ and echogenic content likely clots; (B) large solid-cystic pulsatile lesion noted in the right inguinal region; (C) lesion in connection with common femoral artery via wide neck which showed to and fro spectral wave form (classical Ying Yang flow).

Mentions: A 25-year-old HCV-positive male with a history of IV drug abuse for the past 3 years presented to our institution with complaint of pain lower abdomen and frank hematuria after receiving a minimal blow to his lower abdomen by his 4-year-old daughter during her play 6 days back. On arrival to our emergency room, the patient was conscious oriented tachycardic with a diffuse nonpainful nontender swelling in his right groin. Rest of his vitals and general examination was within normal limits. Distal pulsation in the right leg was present. His hemoglobin was 6.3 g% and CBC was high. Ultrasonogram of abdomen and pelvis revealed distended urinary bladder with clots and pseudoaneurysm of right common femoral artery measuring ∼112 × 69 × 87 mm (Fig. 1). The patient was planned for urinary bladder exploration along with evacuation of clot by urology team by cystoscopy after adequate resuscitation. During cystoscopy, nothing was visible due to massive clot inside the bladder which was incompletely evacuated so three-way Foley catheter was left in situ for continuous postoperative irrigation. Postoperatively, hematuria continued despite transfusion and, hence, emergent abdominal pelvic CT scan was performed.Figure 1:


Femoral pseudoaneurysm rupturing into urinary bladder: A rare presentation.

Shrestha KR, Luitel BR, Shrestha U, Shrestha UK - J Surg Case Rep (2015)

Arterial Doppler pictures: (A) urinary bladder with Foley's in situ and echogenic content likely clots; (B) large solid-cystic pulsatile lesion noted in the right inguinal region; (C) lesion in connection with common femoral artery via wide neck which showed to and fro spectral wave form (classical Ying Yang flow).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400530&req=5

RJV045F1: Arterial Doppler pictures: (A) urinary bladder with Foley's in situ and echogenic content likely clots; (B) large solid-cystic pulsatile lesion noted in the right inguinal region; (C) lesion in connection with common femoral artery via wide neck which showed to and fro spectral wave form (classical Ying Yang flow).
Mentions: A 25-year-old HCV-positive male with a history of IV drug abuse for the past 3 years presented to our institution with complaint of pain lower abdomen and frank hematuria after receiving a minimal blow to his lower abdomen by his 4-year-old daughter during her play 6 days back. On arrival to our emergency room, the patient was conscious oriented tachycardic with a diffuse nonpainful nontender swelling in his right groin. Rest of his vitals and general examination was within normal limits. Distal pulsation in the right leg was present. His hemoglobin was 6.3 g% and CBC was high. Ultrasonogram of abdomen and pelvis revealed distended urinary bladder with clots and pseudoaneurysm of right common femoral artery measuring ∼112 × 69 × 87 mm (Fig. 1). The patient was planned for urinary bladder exploration along with evacuation of clot by urology team by cystoscopy after adequate resuscitation. During cystoscopy, nothing was visible due to massive clot inside the bladder which was incompletely evacuated so three-way Foley catheter was left in situ for continuous postoperative irrigation. Postoperatively, hematuria continued despite transfusion and, hence, emergent abdominal pelvic CT scan was performed.Figure 1:

Bottom Line: Femoral pseudoaneurysm is a common occurrence in intravenous drug abuser due to repeated trauma to the femoral artery causing arterial leak contained by the surrounding tissue and does not contain all the layers of arterial wall.Rupture of these aneurysm to exterior is a common presentation while rupture into surrounding structure deemed an emergency surgical attention.Hence, we report an unusual case of rupture of femoral pseudoaneurysm into urinary bladder who presented us with history of hematuria and was successfully managed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, IOM, Kathmandu, Nepal kajanrs@gmail.com.

No MeSH data available.


Related in: MedlinePlus