Spontaneous Rupture of a Deep Femoral Pseudoaneurysm Mimicking Lymphedema After Radical Hysterectomy in a Woman Who Was Receiving Warfarin

Abstract

Pseudoaneurysms of the deep femoral artery have been reported after external injury to the thigh and orthopedic surgery of the femur. We describe our experience with a case of spontaneous rupture of a deep femoral pseudoaneurysm in a woman who was receiving warfarin within the therapeutic range. She received a choledocholithotomy after a radical hysterectomy for uterine cervical cancer (stage IB1). Pulmonary embolism and deep-vein thrombosis developed after choledocholithotomy, and an inferior vena cava filter was left in place permanently. She was receiving warfarin since then. This time, the patient presented with a pseudoaneurysm of the deep femoral artery and a large hematoma in the adductor muscle of the thigh. Swelling of the thigh in this condition resembled the lower-extremity edema that occurs after pelvic lymph-node dissection. Contrast-enhanced computed tomography (CT) was useful for diagnosis of the pseudoaneurysm and evaluation of the extent of muscle damage.




J Med Cases. 2016;7(7):299-302
doi: http://dx.doi.org/10.14740/jmc2543w