0:01

So let's look at this 52-year-old

0:02

woman who presents for cerebral angio.

0:04

Um, and she, you know, had, uh, a

0:07

vascular closure device placement.

0:09

And she presents with sort of chronically

0:10

draining groin access site, very strange.

0:13

So what do you see in ultrasound?

0:14

What, what, what's, what's, what, what gives here?

0:16

So kind of a little yin and yang

0:19

barred, you know, appearance,

0:20

consistent pseudoaneurysm, yin and yang.

0:24

So I'm trying to see in it a little bit here.

0:26

So let's sort of march along and

0:28

kind of see exactly what's going on.

0:30

So she was admitted to vascular

0:31

surgery and brought to the OR for

0:33

exploration of the right groin.

0:35

And so what we see here is, you know, a

0:36

femoral artery cut down was performed.

0:38

Primary repair of the right superficial femoral

0:40

artery pseudohypertension with a nice GSV patch.

0:43

Boom.

0:43

Performed.

0:45

And so a JP drain was placed, non

0:47

latex tubing, Penrose drain inserted.

0:49

And so fluid from the pseudohypertension was

0:51

removed and sent for microbiology analysis.

0:53

And what did it grow?

0:55

Pseudomonas aeruginosa.

0:58

Hate those little guys.

0:59

So this patient was treated

1:00

with 6 weeks of cefepime.

1:01

The Penrose drain was removed.

1:02

The JP drain continued to

1:04

have just significant output.

1:06

About 90 mL for 24 hours.

1:08

So the drain was left in place

1:10

and the patient was discharged.

1:11

The pain was controlled with oral analgesics

1:13

and the patient ultimately tolerated food

1:15

with nausea, vomiting, but you know she was

1:19

actively voiding, she was passing gas and

1:21

she was ambulating with assistance which

1:23

ultimately she ended up improving significantly.