James William Butterworth1, William A Butterworth2, Roxanne Wu3. 1. Department of Surgery, Cairns Base Hospital, Cairns, Queensland, Australia. Electronic address: jamesfomsf@googlemail.com. 2. Department of Anaesthetics, Royal Shrewsbury Hospital, Shrewsbury, UK. 3. Department of Surgery, Cairns Base Hospital, Cairns, Queensland, Australia.
Abstract
BACKGROUND: Delayed presentations of lower limb pseudoaneurysms secondary to penetrating trauma are particularly rare. METHODS: After presentation of this rare case report, we review relevant published literature. RESULTS: We report a rare case of a 55-year-old man with a progressively enlarging mass measuring 15 cm by 15 cm on his right anteromedial thigh 3 years after penetrating trauma. Computer tomography angiogram revealed this to be a large pseudoaneurysm supplied by a side branch artery from the right superficial femoral artery. Using an open approach, the pseudoanerysm was successfully repaired with the side branch oversewn, and the patient made a good recovery being discharged from hospital 4 days later. CONCLUSIONS: Surgeons must retain pseudoaneurysm as a prominent differential for a patient presenting with a progressively enlarging, expansile mass of an extremity after penetrating trauma to ensure urgent investigation and prompt vascular intervention. Both open surgical ablation and endovascular embolization of pseudoaneurysms of the extremities are effective techniques with low rates of complications and morbidity reported in published literature.
BACKGROUND: Delayed presentations of lower limb pseudoaneurysms secondary to penetrating trauma are particularly rare. METHODS: After presentation of this rare case report, we review relevant published literature. RESULTS: We report a rare case of a 55-year-old man with a progressively enlarging mass measuring 15 cm by 15 cm on his right anteromedial thigh 3 years after penetrating trauma. Computer tomography angiogram revealed this to be a large pseudoaneurysm supplied by a side branch artery from the right superficial femoral artery. Using an open approach, the pseudoanerysm was successfully repaired with the side branch oversewn, and the patient made a good recovery being discharged from hospital 4 days later. CONCLUSIONS: Surgeons must retain pseudoaneurysm as a prominent differential for a patient presenting with a progressively enlarging, expansile mass of an extremity after penetrating trauma to ensure urgent investigation and prompt vascular intervention. Both open surgical ablation and endovascular embolization of pseudoaneurysms of the extremities are effective techniques with low rates of complications and morbidity reported in published literature.