The femoral artery pseudoaneurism after gunshot wound presented with thromboembolism

Gunshot wounds could cause fatal consequences in the acute phase as well as life-threatening complications in the late period. A 34-year-old male patient was admitted to emergency services due to gunshot injury. At the time of application, the conscious was open, pulse and blood pressure were detected 140 min. and 90/50 mmHg. On physical examination, there was a single bullet entry hole about 2 cm distal and 3 cm lateral from the umblical cut point of the abdominal anterior axillary line. An exit hole was detected approximately 1 cm above from the left spina iliaca anterior superior. Emergency operation was performed due to extensive intraabdominal hemorr-hagic fluid in abdominal ultrasonography. In the abdominal exploration, intestinal and mesenteric injury were detected and a segmental small bowel resection was performed. On the fifth postoperative day at intensive care unit, the findings of acute ischemic lesions were found out on the left fourth and fifth fingers of leg. A femoral artery pseudoaneurysm was detected in the left femoral artery by CT angio. After the aneurysm was resected, reconstruction with Gore-tex graft was performed. Despite the retraction of the ischemic plate, 4th and 5th finger amputations were performed due to necrosis improvement. In the postoperative follow-up, he was discharged without any additional problems. It should be kept in mind that additional vascular injuries may occur in patients receiving emergency surgery due to intraabdominal gunshot injuries