Title : Infected pseudoaneurysm from septic embolism of the left common iliac artery in a seventy-five-year-old man
Abstract:
Introduction: Infected pseudoaneurysms, though rare, are serious complications arising from septic emboli and pose significant diagnostic and management challenges. The common iliac artery is an unusual site for such aneurysms, accounting for only 2-6% of documented cases. This report details a 75-year-old hypertensive and diabetic male who developed an infected pseudoaneurysm of the left common iliac artery, successfully treated with laparotomy, aneurysmectomy, and ilio-iliac bypass grafting.
Objective: To detail the clinical presentation, diagnostic challenges, and successful multidisciplinary management of an infected pseudoaneurysm of the common iliac artery in a 75-year-old hypertensive and diabetic male.
Case Presentation: The patient, a 75-year-old male with hypertension and diabetes, presented with a two-week history of fever and chills, body malaise, and a three-day history of bilateral knee pain with difficulty ambulating. Previously treated for community-acquired pneumonia and hepatic abscess, he presented afebrile with a swollen, tender left knee and decreased pulses in the left dorsalis pedis. Laboratory findings included a high procalcitonin level of 73.8, CRP of 317.3, and significant pyuria. A CT scan revealed a hepatic abscess and an abscess formation along the left common iliac artery, causing significant stenosis. Blood and urine cultures were positive for Klebsiella pneumoniae, sensitive to Meropenem. Despite initial improvement with Meropenem, a follow-up CT scan revealed a mycotic pseudoaneurysm of the left common iliac artery. The patient underwent successful laparotomy, debridement, aneurysmectomy, and ilio-iliac bypass grafting, recovering well post-operatively without complications.
