Successful Management of Infected Superficial Femoral Aneurysm Caused by Citrobacter koseri / 日本心臓血管外科学会雑誌

ABSTRACT

A 77-year-old man with diabetes mellitus and hypertension presented with acute onset of pain and swelling of the right thigh. Physical examination showed a pulsatile mass in the mid-portion of the right thigh. Computed tomography revealed the presence of a 7-cm diameter aneurysm at superficial femoral artery with gas shadow around the aneurysmal wall. A diagnosis of infected superficial femoral aneurysm was made and emergency surgery was undertaken. The total resection of the aneurysmal wall, debridement of necrotic tissues including part of sartorius and quadriceps muscles were done. Femoro-popliteal bypass through subcutaneous route using a 6-mm diameter Dacron prosthesis was used as the mean of vascular reconstruction procedure. <i>Citrobacter koseri</i> was cultured from the infected aneurysmal wall. The antibiotic treatment was continued for total of 2 weeks. Although additional debridement was required, the patient was amkulabony when discharged on the 37th postoperative day.