Busch Albert, Lorenz Udo, Tiurbe George Christian, Bühler Christoph, Kellersmann Richard
Department of General, Visceral, Vascular and Paediatric Surgery University Clinic of Würzburg, Oberdürrbacher Strasse 6, Würzburg, D-97080, Germany.
J Med Case Rep. 2013 Mar 18;7:75. doi: 10.1186/1752-1947-7-75.
Groin infections resulting in arterial bleeding due to bacterial vessel destruction are a severe challenge in vascular surgery. Patients with them most often present as emergencies and therefore need individualized reconstruction solutions.
Case 1 is a 67-year-old man with infectious bleeding after an autologous reconstruction of the femoral bifurcation with greater saphenous vein due to infection of a bovine pericard patch after thrombendarterectomy. Case 2 is a 35-year-old male drug addict and had severe femoral bleeding and infection after repeated intravenous and intra-arterial substance abuse. Both patients were treated with an autologous obturator bypass of the superficial femoral vein. We review the current literature and highlight our therapeutic concept of this clinical entity.
Treatment should include systemic antibiotic medication, surgical control of the infectious site, revascularization and soft tissue repair. An extra-anatomical obturator bypass with autologous superficial femoral vein should be considered as the safest revascularization procedure in infections caused by highly pathogenic bacteria.
因细菌破坏血管导致腹股沟感染并引发动脉出血，这在血管外科中是一项严峻挑战。患有此类疾病的患者大多以急症形式出现，因此需要个体化的重建解决方案。
病例1是一名67岁男性，在因血栓内膜切除术后牛心包补片感染，采用大隐静脉对股动脉分叉进行自体重建后出现感染性出血。病例2是一名35岁男性吸毒者，在反复静脉和动脉内滥用药物后出现严重的股部出血和感染。两名患者均接受了股浅静脉自体闭孔旁路移植术治疗。我们回顾了当前的文献，并强调了我们针对这一临床实体的治疗理念。
治疗应包括全身抗生素用药、对感染部位进行手术控制、血运重建和软组织修复。对于由高致病性细菌引起的感染，采用自体股浅静脉进行解剖外闭孔旁路移植术应被视为最安全的血运重建手术。
