PP053 Pseudoaneurysm of the femoral artery following blunt trauma

Abstract

Introduction:

An aneurysm is the enlargement of an artery caused by weakness in the arterial wall. If an aneurysm ruptured, it can lead to fatal complications. The femoral vessels accounts for 1/3 of traumatic arterial injuries. False or pseudoaneurysms of the femoral artery frequently associated with femur fractures. However, few isolated case related to blunt trauma causing pseudo aneurysm. Here we presented a case of pseudo aneurysm of the left common femoral artery following blunt trauma.

Case report:

59years old, Malay gentleman was accidentally hit by fishing rod 3weeks ago over his left inguinal region. There was no open wound so he did not seek medical attention. Three weeks later, he presented to emergency department with painful swelling over the left inguinal region, pain score 10/10. Upon examination over left inguinal region, pulsatile mass felt. Bedside ultrasound finding was “yin yang” appearance with pseudoaneurysm 2.6x2.6cm. Patient was referred to surgical team and left inguinal and extraperitoneal exploration operation was done. However it was an open and closed surgery, surgeon was unable to find the plane. Patient was eventually referred to neurovascular team.

Discussion and conclusion:

An early intervention in managing aneurysm can reduce the mortality and better outcome. Surgeons should be aware of the injury and how to treat it. As this complication of blunt trauma is rare. Isolated case reported 3 patients in whom diagnosis as pseudo aneurysm initially was missed and led to disastrous outcome. In our case, emergency physician had detected pseudoaneurysm of the femoral artery via ultrasound, but surgeon did not refer to another facility with neurovascular specialty.