Atraumatic Bi-femoral Axillary Bypass Graft Non-anastomotic Disruption With Pseudoaneurysm Formation Detected by Doppler Ultrasound.

Autor:	Nesbit DA; Department of Emergency and Hospital Medicine/University of South Florida Morsani College of Medicine, Lehigh Valley Health Network, Bethlehem, USA., Wang C; Department of Emergency and Hospital Medicine/University of South Florida Morsani College of Medicine, Lehigh Valley Health Network, Bethlehem, USA., Grenz PM; Department of Emergency and Hospital Medicine/University of South Florida Morsani College of Medicine, Lehigh Valley Health Network, Bethlehem, USA., Roth KR; Department of Emergency and Hospital Medicine/University of South Florida Morsani College of Medicine, Lehigh Valley Health Network, Bethlehem, USA., Eygnor JK; Department of Emergency and Hospital Medicine/University of South Florida Morsani College of Medicine, Lehigh Valley Health Network, Bethlehem, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Oct 30; Vol. 14 (10), pp. e30871. Date of Electronic Publication: 2022 Oct 30 (Print Publication: 2022).
DOI:	10.7759/cureus.30871
Abstrakt:	Bi-femoral axillary bypass graft placement is a well-known and typically safe procedure. It is generally indicated for patients with advanced peripheral vascular disease, aortoiliac occlusive disease, or infectious artery disease. In rare cases, the graft can be fractured or dislodged after placement, though most often, this occurs almost exclusively at the anastomosis site, secondary to blunt trauma. Using ultrasonic imaging is a reliable method of detecting these fractures. We present a case of a bi-femoral axillary bypass graft fracture in a 68-year-old male with the development of a pseudoaneurysm in the right lateral abdominal wall. The patient reported spontaneous development of a "strange" sensation in his right lower abdomen and a "painful lump" upon waking. Physical examination showed a small right lower quadrant outpouching which was pulsatile on palpation. The initial workup included a bedside ultrasound which showed a fractured graft with the fluid collection and a Doppler signal. Vascular surgery was immediately consulted for evaluation, and the patient was taken to the operating room for emergent surgical repair. CT angiography confirmed a successful operation in which an 8 mm graft was placed to anastomose the original bypass graft fracture site. The patient remained stable postoperatively and was discharged without further complications. This report highlights the importance of using ultrasonography for the immediate identification of potential graft complications to prevent serious complications and expedite definitive management. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Nesbit et al.)
Databáze:	MEDLINE
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