PMC5440756_01
a) Coronal section from CT Angiogram and b) axial section demonstrating right femoral pseudoaneurysm and localised collection.
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The femoral pseudoaneurysm was identified on Duplex ultrasound and further confirmed with CT angiography before being taken to theatre (Fig. 1). The haematoma was explored via a groin incision, however, heavy bleeding and deeply inflamed tissues made proximal control difficult to achieve so the incision was extended to the abdomen for a pre-peritoneal approach.
PMC5440756_02
Right profunda femoris pseudoaneursym with contrast extravasation.
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Due to difficulty obtaining IV access he was initially commenced on oral Co-Amoxiclav 500/125 mg, which was switched to IV Meropenam 1 g TDS following insertion of a central line. Due to persistent pyrexia, he had a contrast CT scan to exclude a psoas abscess, which identified a large 7 x 8 cm actively bleeding femoral pseudoaneurysm (Fig. 2).
PMC5440756_03
Axial section from CTA showing right femoral pseudoaneurysm with diffuse heavily inflamed tissues and gas extending into the posterior thigh compartment and into the pelvis.
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PMC5440756_03_gr3.jpg
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A 33 year old male presented to the emergency room systemically septic with raised inflammatory markers and a right groin swelling, he was commenced on IV Meropenam 1 g TDS and Linezolid 450 mg BD and a contrast CT scan confirmed a pseudoaneurysm of the profunda femoris artery alongside a complex deep groin and pelvic collection (Fig. 3).
PMC5440756_04