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[Inguinal hernia as a diagnostic error in ruptured groin aneurysm]
E P Cosentini1, T Hölzenbein, M Riegler
1Klinische Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Wien.
VASA. Zeitschrift Fur Gefasskrankheiten
|June 22, 2001
Summary
Anastomotic aneurysms, a rare complication after arterial surgery, can develop years later. This case highlights a large groin aneurysm 10 years post-femoro-tibial bypass, successfully treated with resection and re-grafting.
Area of Science:
- Vascular Surgery
- Aneurysm Research
- Arterial Grafting
Background:
- Anastomotic aneurysms occur in 0.5%-5.0% of arterial surgeries, particularly with fabric grafts in the groin.
- Delayed complications following arterial reconstruction require careful diagnosis and management.
Observation:
- A 64-year-old male presented with a large left groin mass 10 years after an autologous femoro-tibial vein graft.
- Initial diagnosis was incarcerated inguinal hernia, but imaging revealed a 13 cm aneurysm.
Findings:
- The aneurysm was successfully resected, and orthotopic femoro-profundal vein graft reconstruction was performed.
- The graft was covered with a sartorius muscle flap, ensuring a favorable postoperative outcome.
Implications:
- This case underscores the importance of considering anastomotic aneurysms in patients with a history of arterial surgery presenting with groin masses.
- Progression of underlying arteriosclerotic disease is a likely etiology for late-onset aneurysms.
- Surgical repair involving resection, autologous grafting, and muscle flap coverage offers an effective treatment strategy.