학술논문

Extra-anatomical Bypass for Vascular Infection in the Groin / 動脈に及ぶ鼠径部感染に対し非解剖学的バイパスにて治療を行った2 例
Document Type
Journal Article
Source
日本血管外科学会雑誌 / Japanese Journal of Vascular Surgery. 2014, 23(4):782
Subject
extra-anatomical bypass
groin infection
非解剖学的バイパス術
鼠径部感染
Language
Japanese
ISSN
0918-6778
1881-767X
Abstract
Vascular infections in the groin require both infection control and arterial revascularization for limb salvage. We treated two cases of arterial bleeding caused by vascular infections in the groin by debridement with extra-anatomical bypass. Case 1 was a 74-year-old woman with a history of right inguinal lymph node metastasis of pudendum carcinoma. She underwent exclusion of the right inguinal lymph nodes and right femoral vein. A femoral wound infection with arterial bleeding occurred 2 months later. We performed extra-anatomical bypass (right external iliac artery-right femoral artery bypass) and ligation of the right external iliac artery, and right superficial and deep femoral arteries. Case 2 was a 73-year-old woman who underwent coronary angioplasty for acute myocardial infarction. Post catheterization, an inguinal hematoma occurred and a groin infection with arterial bleeding developed 1 month later. We performed extra-anatomical bypass (right axillary-right popliteal artery bypass) and ligation of the right femoral artery. Femoral arterial re-bleeding occurred 3 months later. We performed coil embolism of the right external iliac artery and right deep femoral artery, and ligated right superficial femoral artery proximally. In both cases, the infections were controlled and blood flow to the leg was maintained. Extra-anatomical bypass is a good option for vascular infections in the groin.