FEMORAL ARTERY ENDARTERITIS IS STILL A RELATIVELY UNKNOWN ENTITY ESPECIALLY AMONG VASCULAR SURGEONS AND CARDIOLOGISTS.NO DOUBT ITS REPORTED INCIDENCE IN LITERATURE IS LESS THAN 1%.


WHAT EXACTLY IS FEMORAL ENDARTERITIS?BASICALLY ITS THE INFECTION OF THE FEMORAL ARTERY AND ITS SURROUNDING TISSUE POST CONVENTIONAL ANGIOGRAM.PATIENT PRESENTS TO YOU WITH PAIN IN THE GROIN GENERALLY WITHIN A WEEK AFTER ANGIO ALONG WITH SYMPTOMS OF SEPSIS AND LOCALISED INFECTION /CELLULITIS IN THE GROIN EXTENDING INVARIABLY OVER THE ABDOMINAL WALL WITH PUS DISCHARGE AT THE PUNCTURE SITE.


WE REPORT A CASE OF FEMORAL ARTERY ENDARTERITIS IN A 73 YEARS OLD MAN WHO REPORTED TO OUR CENTRE IN MOHALI WITH SYMPTOMS OF SEPSIS(HIGH GRADE FEVER,LOW HEAMOGLOBIN,LEUKOCYTOSIS,DERANGED RENAL FUNTION TESTS AND REACTIVE THROMBOCYTOSIS)ALONG WITH SEVERE GROIN PAIN AND SWELLING EXTENDING OVER THE ABDOMINAL WALL.THIS PATIENT UNDERWENT ANGIOGRAM THROUGH THE FEMORAL ROUTE SOME TEN DAYS BACK.HE WAS PUT ON STRONG ANTIBIOTICS BUT TO NO AVAIL.A DOPPLER SCAN AND A CT ANGIO RULED OUT MYCOTIC PSEUDOANEURYSM OF THE FEMORAL VESSELS.


WE TOOK HIM UP FOR IMMEDIATE SURGERY AND FOUND FLORID INFECTION AND CREAMISH YELLOW COLORED PUS EXTENDING FROM THE PUNTURE SITE TO THE GROIN THE ABDOMINAL WALL (SUGGESTIVE OF STAPYLOCOCCUS INFECTION).WE DID A WIDE DEBRIDEMENT OF THE GROIN AND THE FEMORAL ARTERIAL WALL AND REPLACED IT WITH VENOUS PATCH.THE FEMORAL ARTERY WAS COVERED WITH THE TISSUE AROUND TO PREVENT A BLOWOUT.THE GROIN IS LEFT OPEN TILL THE LOCAL INFECTION SUBSIDES AND THE PATIENT IS READY FOR SECONDARY SUTURING.


I FEEL THOUGH UNCOMMON BUT STILL THIS ENTITY LARGELY GOES UNREPORTED /UNDERREPORTED.I HAPPENED TO TALK ABOUT THIS WITH MY COLLEAGUES IN CARDIOLOGY AND VASCULAR FRATERNITY BUT ALL I GET TO KNOW IS THAT THEY HAVE READ ABOUT IT BUT NEVER SEEN IT.ANYWAYS IN A SITUATION LIKE THIS TREATMENT OPTIONS ARE LIMITED AND THE OPERATING SURGEON HAS TO BE VERY AGGRESSIVE IN HIS LINE OF ACTION FOR THESE PATIENTS MAY NEED REPEATED DEBRIDEMENTS AND A POSSIBLE OBTURATOR FORAMEN BYPASS TO SAVE THE LIMB FROM AMPUTATION.
THE ABOVE PICTURE PUBLISHED SHOWS YOU THE SITE OF PUNCTURE WITH PUS DISCHARE ALONG WITH CELLULITIS OF THE NEIGHBOURING TISSUE