A rare case of femoral artery saccular aneurysm caused by tuberculosis in a male patient: A case report and review of literature

INTRODUCTION: Tuberculosis (TB) is still a major global health issue. In over 75 % of all cases of mycotic aneurysm, TB spreads directly by eroding through the vascular wall. Aortic and innominate arteries are frequently the sites of tubercular aneurysms, primarily due to contiguous dissemination from pulmonary infection sites. We report a case of a saccular aneurysm at the distal common femoral artery associated with tuberculosis. CASE PRESENTATION: A 34-year-old man had the chief complaint of a voluminous pulsatile mass in the left thigh. We found a bruit on auscultation examination at the site of the mass. A computed tomography (CT) angiography showed a saccular aneurysm at the distal common femoral artery and stenosis at the proximal femoral profunda artery. A chest CT scan was conducted, and the result showed a ground-glass appearance and multiple enlarged lymph nodes. CLINICAL DISCUSSION: The patient was treated surgically by resection of the aneurysm and reconstruction with an inter-positional saphenous vein graft. Later, he was treated with a drug regimen for tuberculosis by pulmonologist. The patient was discharged with no post-operative complications. CONCLUSION: Patients with femoral artery aneurysms are at high risk of rupture and death by exsanguination. It can be a severe complication of tuberculosis, especially in immunocompromised patients. Although this was a very rare case, all surgeons must be aware. A combination of medical and surgical intervention is imperative. Careful clinical care postoperatively is mandatory because of the risk of repetitive anastomotic aneurysms and recurrent aneurysms in another vessel.