Wiki Excision and ligation of right thigh pseudoaneurysm

Messages
202
Location
Greer, SC
Best answers
0
Indication:
Patient is a 35-year-old male with bacterial endocarditis. He was noted to have a 5 cm pseudoaneurysm in the mid thigh posterior to the femur which is presumed to be infectious in nature. He is here for a excision of the pseudoaneurysm and ligation of the profunda branch that was feeding it. Preop CTA did not show any connection to the SFA.

Postoperative diagnosis:
Right thigh pseudoaneurysm

Procedure:
Excision and ligation of right thigh pseudoaneurysm

Specimen:
Right thigh pseudoaneurysm sent for pathology and microbiology culture

Complications:
None

Technique:
Patient was taken to the operating placed on the table in a supine position prepped and draped in standard fashion. A longitudinal incision of approximately 15 cm length was made on the anterior medial thigh and sharp dissection was carried down through subcutaneous tissue. The fascia was opened and on the medial side of the rectus for Morris muscle in between the fibers sharp dissection with electrocautery was carried down all the way to the femur. Along the medial side of the fever some fibrous tissue was divided and the pseudoaneurysm was exposed. At the proximal end of the pseudoaneurysm gentle dissection revealed that the feeding artery and vein and these were ligated and transected. Next the pseudoaneurysm was carefully peeled away with a combination of blunt dissection and
Electrocautery from the surrounding tissues.

The distal end of the pseudoaneurysm was then clamped transected and the stump was suture-ligated. Some small intramuscular bleeders in the depth of the wound were suture-ligated with 2-0 silk suture. Good hemostasis was established. The wound was copiously irrigated with antibiotic seen solution and a #15 round JP drain was placed. This was brought out in a posteromedial position. The entire pseudoaneurysm was completely removed from the SFA and the SFA was not exposed.

Next 2 PDS sutures were used to close the deep layers as well as the superficial layers in a running fashion and staples were used for the skin.

Specimen was sent for microbiology and pathology.

Sterile dressings were applied and the patient was taken to recovery room in stable condition sponge and instrument counts were correct

would these be correct?
35141
37618
 
Top