Ruptured femoral artery pseudoaneurysm revealed by necrotizing fasciitis complicated with lower limb acute ischemia

Infectious pseudoaneurysm of the superficial femoral artery is an uncommon pathological condition that requires a rapid prompt management. Ruptures remain an unpredictable complication during the natural evolution of pseudoaneurysmal pathology. The aim of this paper is to assess clinical manifestations and to analyze the different methods of management. We report a case of a 69-year-old male with past medical history of tobacco-alcoholic abuse. He presented to our department for necrotizing fasciitis of the left lower limb associated with stage IIb of acute ischemia. The etiological investigation revealed an Escherichia Coli pseudoaneurysm of distal segment of superficial femoral artery. Thus, the patient underwent a resection of pseudoaneurysm and tissue necrosis associated with direct revascularization. Septic pseudoaneurysm of the superficial femoral artery represents a medical emergency that involves limb functionality and vital prognosis. Among the therapeutic arsenal, the appropriate treatment should be discussed in a multidisciplinary approach.