A Cadaveric Case Study on the Abdomen: A Temple of Surprises

Femoro-femoral bypass grafts (FFBG) are performed to connect the major vessels of the lower extremities, such as the femoral arteries, to treat patients who have injured or occluded iliac arteries. Typically, patients with multiple comorbidities, such as heart failure, aneurysms, or diabetes, have a significantly higher risk of complications for open, invasive procedures to correct lower limb ischemia. This graft poses as an effective, less invasive option to treat lower-limb ischemia for higher-risk patients. This case study presents a finding of FFBG in an 82-year-old male cadaver during cadaveric dissection in the gross anatomy lab at Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania. Based on the initial findings of cardiomegaly with a triple coronary artery bypass graft (CABG) and pulmonary hypertension in the thoracic cavity and evidence of massive umbilical hernioplasty involving extensive mesh repair, our initial assumption of an FFBG placement in this cadaver was to increase perfusion to lower limbs, circumventing the need for surgical intervention due to the above-mentioned comorbidities, which act as risk factors. However, the discovery of a massive abdominal aortic aneurysm (AAA) measuring 26 cm in circumference with evidence of dissection of its wall and the presence of a stent within the aorta and common iliac arteries placed there as an endovascular aneurysm repair (EVAR) procedure came as a surprise. Publication of such findings provides awareness to curious individuals about the existence of multiple health concerns an individual suffers and how the medical as well as surgical teams work together to provide optimal treatment care to improve their standard of living and prolong their lifespan.