achilles
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A physician is called to see a 69-year-old woman who underwent cardiac catheterization via the right femoral artery earlier in the morning. She is now complaining of a cool right foot. Upon examination she has a pulsatile mass over her right groin with loss of her distal pulses, and auscultation reveals a bruit over the point at which the right femoral artery was entered. Which of the following is the most likely diagnosis?
A. Cholesterol emboli syndrome
B. Femoral aneurysm
C. Femoral hernia
D. Femoral pseudoaneurysm
E. Retroperitoneal hematoma
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| Jinx
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d
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| sachida
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I thought B and it seems I was wrong. It should be D
Found this on pubmed
Diagnosis and treatment of iatrogenic femoral artery pseudoaneurysm: a review.
Kronzon I.
Department of Medicine, New York University School of Medicine, New York, USA.
A pseudoaneurysm is a pulsatile hematoma that communicates with an artery through a disruption in the arterial wall. Femoral pseudoaneurysm is a common complication of invasive procedures. It occurs in 0.1% to 0.2% of diagnostic angiograms and 3.5% to 5.5% of interventional procedures. Longer procedures, large-bore catheters, anticoagulation, and a faulty lower site of puncture are associated with a higher incidence of femoral pseudoaneurysm. Pseudoaneurysms are associated with the characteristic findings of a pulsatile mass, a palpable thrill, and an audible to-and-fro murmur. The diagnosis is confirmed by imaging of the pseudoaneurysm. A femoral arterial duplex study is the diagnostic imaging modality of choice. It can show the pseudoaneurysm, the degree of clotting, the communication with the femoral artery, and the blood flow velocity pattern within the artery, the communication, and the pseudoaneurysm. Small (less than 2 cm) femoral pseudoaneurysms clot spontaneously and usually require no treatment. Larger femoral pseudoaneurysms may lead to complications including rupture and compression of the adjacent femoral vein (with resulting venous thrombosis) or of the femoral nerve. Treatment may be surgical. However, recently it has been shown that direct, noninvasive compression of the pseudoaneurysm stops the blood flow in the communication and leads to pseudoaneurysm clotting and obliteration.
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| achilles
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the answer is D and sachida has already given a beautiful explanation.
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