Manvar-Singh Pallavi, Segal Michael, Etkin Yana, Dodla Ranjith, Landis Gregg, Krishnasastry Kambhampaty V, Frankini Larry
Division of Vascular Surgery, Department of Surgery, Northwell Health, New Hyde Park, NY, USA.
Department of Surgery, Wyckoff Heights Medical Center, Brooklyn, NY, USA.
J Surg Case Rep. 2019 Nov 11;2019(11):rjz271. doi: 10.1093/jscr/rjz271. eCollection 2019 Nov.
We present an interesting case of a 66-year-old male who had acute testicular infarction following a right common femoral artery to left profunda femoris artery bypass with advanced symptoms of claudication. Angiography in the preoperative period demonstrated the extent of peripheral arterial disease present, revealing a calcified aorta, partially occluded left hypogastric artery, occluded left external iliac, common femoral and superficial femoral arteries and an occluded right hypogastric artery. A bypass was performed without any initial complications and subsequent relief of symptoms of claudication and rest pain. Postoperative scrotal pain and follow-up duplex demonstrated lack of perfusion of the testicle necessitating orchiectomy. This case serves to illustrate the importance of preserving collateral vessels as a technical consideration, as well as presenting a rare potential complication.
我们报告了一例有趣的病例，一名66岁男性在进行右股总动脉至左股深动脉搭桥术后发生急性睾丸梗死，并伴有严重的间歇性跛行症状。术前血管造影显示了外周动脉疾病的范围，发现主动脉钙化、左下腹动脉部分闭塞、左髂外动脉、股总动脉和股浅动脉闭塞以及右下腹动脉闭塞。手术搭桥过程顺利，术后间歇性跛行和静息痛症状缓解。术后出现阴囊疼痛，后续的双功超声检查显示睾丸缺乏灌注，因此需要进行睾丸切除术。该病例说明了在技术层面保留侧支血管的重要性，同时也展示了一种罕见的潜在并发症。
