Obturator Bypass Surgery in a Patient with an Infected Femoral Artery Pseudoaneurysm with Sepsis

패혈증을 동반한 감염된 대퇴동맥 가성동맥류 환자에서 폐쇄공우회술을 이용한 치험

  • Jun, Hee Jae (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje University College of Medicine) ;
  • Han, Il Yong (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje University College of Medicine) ;
  • Yoon, Young Chul (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Yang Haeng (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje University College of Medicine) ;
  • Hwang, Youn Ho (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje University College of Medicine) ;
  • Cho, Kwang Hyun (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje University College of Medicine)
  • 전희재 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 한일용 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 윤영철 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 이양행 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 황윤호 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 조광현 (인제대학교 의과대학 부산백병원 흉부외과학교실)
  • Received : 2008.08.12
  • Accepted : 2008.09.23
  • Published : 2009.02.05

Abstract

Infection of the both native and prosthetic vessels in the groin is a very serious disease because of recurrent arterial rupture and sepsis, and both these complications can cause death. The successful treatment of groin infection, including infection of the femoral artery, requires extensive excision of the infected tissues and restoration of the circulation. We experienced a case of obturator bypass in a patient with an infected femoral artery pseudoaneurysm and accompanying sepsis, and this occurred after performing a transfemoral angiogram in an A-V fistula of the carotid artery, and the patient also displayed intracranial hemorrhage.

자가 또는 이식혈관의 감염은 반복적인 파열 및 패혈증으로 인해 환자의 생명을 위협하는 심각한 질병이다. 대퇴동맥을 포함한 서혜부 감염이 생긴 경우 가장 성공적인 치료원칙은 감염된 조직의 광범위한 절제와 동맥재건술이다. 본원에서는 뇌동정맥루, 뇌출혈환자에서 대퇴동맥을 천자하여 시행한 혈관조영술후 패혈증을 동반한 감염된 가성동맥류가 발생하여 폐쇄공우회술을 이용하여 치험하였기에 보고하는 바이다.

Keywords

References

  1. Shaw RS, Baue AE. Management of sepsis complicating arterial reconstructive surgery. Surgery 1963;53:75-86
  2. Mahoney WD, Whelan TJ. Use of obturator foramen in iliofemoral artery grafting: case reports. Ann Surg 1966;163: 215-20
  3. Donohoe PK, Froio RA, Nasbeth DC. Obturator bypass graft in radical excision of inguinal neoplasm. Ann Surg 1967; 166:147-9 https://doi.org/10.1097/00000658-196707000-00018
  4. Hegarty JC, Linton PC, McSweeney ED. Revascularization of lower extremity through the obturator canal. Arch Surg 1969;98:35-8 https://doi.org/10.1001/archsurg.1969.01340070053007
  5. Shin MJ, Suh BY, Kwun KB. A case of limb salvage by obturator foramen bypass with Gortex graft. J Korean Society Vasc Surg 1991;7:48-53
  6. Park KH, Kim DI, Huh S, Chang HS, Lee BB. Experiences of iliopopliteal bypass through obturator foramen. J Korean Society Vasc Surg 1991;7:48-53
  7. Erath HG Jr, Gale SS, Smith BM, Dean RH. Obturator foramen grafts: the preferable alternate route? Ann Surg 1982; 48:65-8
  8. Sheiner NM, Sigman H, Stilman A. Unusual complication of obturator foramen arterial bypass. J Cardiovasc Surg 1969; 10:324-8