Abstract
An 84-year-old man, who had attended our hospital as an outpatient with complete occlusion of the right superficial femoral artery (SFA), was hospitalized with pyelonephritis. He presented with acute onset of swelling and pain in the right thigh. Based on computed tomography (CT) findings, we made a diagnosis of pseudoaneurysm of the SFA with a very large abscess, and planned a 2-stage operation. In the initial operation for limb salvage, we ligated the SFA which was feeding the pseudoaneurysm and performed femoroposterior tibial artery bypass via a subcutaneous route using a saphenous vein graft. In the second operation we performed resection of the aneurysm and open drainage of the abscess. Escherichia coli was cultured from the abscess, similar to findings of pyelonephritis. The patient was ambulatory when discharged on the 67th postoperative day.
