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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

Axial CECT abdomen and pelvis pmages: (A) femoral pseudoaneurysm (marked with star), urinary bladder with clots (arrowhead) and Foley's catheter in situ (arrow); (B) communication between pseudoaneurysm and urinary bladder which was overlooked preoperatively (marked by arrow).
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RJV045F2: Axial CECT abdomen and pelvis pmages: (A) femoral pseudoaneurysm (marked with star), urinary bladder with clots (arrowhead) and Foley's catheter in situ (arrow); (B) communication between pseudoaneurysm and urinary bladder which was overlooked preoperatively (marked by arrow).

Mentions: On contrast enhanced CT, a right common femoral pseudoaneurysm of size 12.5 × 6 × 6.5 cm was noted with intra-abdominal extension. Huge clot was also noted in the bladder with no obvious lesion in the kidney, ureter and bladder (Fig. 2). Thus, the patient was planned for exploration of pseudoaneurysm and urinary bladder. On exploration of right groin, there was a huge pseudoaneurysm in the groin extending above the inguinal ligament with 1 l of clot and blood (Fig. 3). Femoral artery was transected and proximal and distal ends were taken into control. Proximal end of femoral artery was ligated, and the leg was examined for distal saturation which was normal, so the distal end was also ligated. After addressing the femoral artery, the urinary bladder was explored. A small rent (∼0.5 × 0.5 cm) was noted in the right lateral wall of the bladder which was communicating with the wall of the pseudoaneurysm along with 2 l of blood and clot in the bladder. Thus, the enigma of hematuria was solved. Bladder was repaired according to standard technique and drain was kept in retroperitoneal space and abdomen was closed.Figure 2:


Femoral pseudoaneurysm rupturing into urinary bladder: A rare presentation.

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

Axial CECT abdomen and pelvis pmages: (A) femoral pseudoaneurysm (marked with star), urinary bladder with clots (arrowhead) and Foley's catheter in situ (arrow); (B) communication between pseudoaneurysm and urinary bladder which was overlooked preoperatively (marked by arrow).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

RJV045F2: Axial CECT abdomen and pelvis pmages: (A) femoral pseudoaneurysm (marked with star), urinary bladder with clots (arrowhead) and Foley's catheter in situ (arrow); (B) communication between pseudoaneurysm and urinary bladder which was overlooked preoperatively (marked by arrow).
Mentions: On contrast enhanced CT, a right common femoral pseudoaneurysm of size 12.5 × 6 × 6.5 cm was noted with intra-abdominal extension. Huge clot was also noted in the bladder with no obvious lesion in the kidney, ureter and bladder (Fig. 2). Thus, the patient was planned for exploration of pseudoaneurysm and urinary bladder. On exploration of right groin, there was a huge pseudoaneurysm in the groin extending above the inguinal ligament with 1 l of clot and blood (Fig. 3). Femoral artery was transected and proximal and distal ends were taken into control. Proximal end of femoral artery was ligated, and the leg was examined for distal saturation which was normal, so the distal end was also ligated. After addressing the femoral artery, the urinary bladder was explored. A small rent (∼0.5 × 0.5 cm) was noted in the right lateral wall of the bladder which was communicating with the wall of the pseudoaneurysm along with 2 l of blood and clot in the bladder. Thus, the enigma of hematuria was solved. Bladder was repaired according to standard technique and drain was kept in retroperitoneal space and abdomen was closed.Figure 2:

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