Life-Threatening, Bleeding Pseudoaneurysm of the External Iliac Artery in the Setting of an Infected Total Hip Arthroplasty from Pasteurella multocida

Abstract

We present a bleeding, infected (mycotic) pseudoaneurysm from the organism Pasteurella multocida. The patient presented septic from an infected total hip arthroplasty and was treated with surgical debridement, component retention, and antibiotics. She re-presented with hip pain and a marked hemoglobin decrease. Vascular studies revealed a pseudoaneurysm of the external iliac artery and large hematoma secondary to contiguous spread of her hip infection. The pseudoaneurysm was treated with an endovascular stent before further debridement surgery to avoid exsanguinating hemorrhage with surgical release of her tamponade. This case demonstrates the utmost importance of recognizing and treating vascular pathology in a patient with an infected prosthetic hip, large hematoma, and decreased hemoglobin.

Keywords

• Hip arthroplasty
• Infection
• Pasteurella
• Pseudoaneurysm
• Vascular complication
• External iliac pseudoaneurysm