EXPERIENCE OF TREATING MYCOTIC ANEURYSM OF FEMORAL ARTERY AT FOUNDATION UNIVERSITY MEDICAL COLLEGE HOSPITAL, RAWALPINDI

Mycotic Aneurysm

Abstract

Introduction

The term Mycotic Aneurysm was used by Osler in 1885, for the first time [1] for aneurysms caused by septic emboli. Mycotic Aneuysm are potentially life threatening with mortality up to 67% [2]. The reported incidence of the often fatal mycotic aneurysm rupture ranges from 10% for those infected with gram positive organisms to 83% for those with gram negative organism [2]. Rupture of the mycotic aneurysm may occur within one week from the Initial sepsis [2].

Mycotic aneurysm can occur anywhere, but the most common location is the femoral artery. It is formed secondary to localized infection, which is often the result of direct injury and may follow intravascular drug abuse [4]. Abdali H has given 32.75% incidence of mycotic aneurysm in intravascular drug users [3].

Prompt and accurate diagnosis is essential for proper management. Duplex ultrasonography is the preferred diagnostic modality in groin. The principle of treatment is surgical ligation and excision of mycotic aneurysm with femoral by pass.

We report our experience with two patients suffering from mycotic aneurysm of femoral artery who were drug addicts for more than twenty years. In both patients the diagnosis was missed initially and presented with massive bleeding wound.