Ruptured Mycotic Aneurysm of the Iliofemoral Artery; A case Report

Medicine Research project

Ruptured mycotic iliofemoral artery aneurysm is rare and its incidence is not well documented, however the risk of rupture of mycotic aneurysms in general can reach up to 45%. Aneurysms in the iliofemoral artery has an insidious presentation with its natural history, tendency to embolize or rupture are not well known. This is a case of a 53 year-old male, hypertensive and 25-year pack smoker, who presented with a left pulsating inguinal mass, initially diagnosed as incarcerated inguinal hernia and was scheduled for herniorrhaphy. During the hospital stay CT scan was done, pseudoaneurysms was considered, CT angiography was then requested, but prior to the scheduled diagnostic test the patient developed sudden claudication and ischemic changes on the left lower extremity prompting for an emergency inguinal exploration which revealed a ruptured iliofemoral artery aneurysm enveloped by fibrosis and necrotic tissues. Fermoro-femoral extra-anatomic bypass left to right was done. Arterial wall culture, Methicillin resistant Staphylococcus aureus (MRSA). A high index of suspicion is warranted, because appropriate treatment will certainly affect the outcome, as they are associated with high morbidity and mortality.