Its been a while when I last posted.Was keeping busy.Hope you guys had a terrific Diwali.Some interesting and at times pleasant challenges keep coming across to you in your day to day chores and you feel blessed that God has chosen you among others to do the needful.
On the night of dusshera we had a difficult case to handle.This guy in his late thirties came with massive bleeding from his groin area along with forefoot gangrene.A detailed history was not surprising though.He was a parentral drug addict who used to take injections in his femoral artery unabated.Examination revealed he had severe infection of the groin which was extending way into his right retroperitoneal space and involved quite a bit of the abdominal wall.Doing a Obturator foramen bypass was ruled out due to the above mentioned findings.So was doing a axillo-popliteal bypass.I being not a keen follower of this surgery(AX-POP) is a different issue altogether.The only option left was to do a perineal infrascrotal femoro-femoral crossover bypass.FortunatelyI had experience doing same kinda case a year back which is published in my blog in 2010.Encouraged by the outcome in that case we went ahead with the same procedure in this gentleman.Its about a month now and this guy is doing great.He had three subsequent surgeries to heal his groin and foot wounds and now is back on his legs.Really happy for him.
To me this is a fantastic vascular surgical procedure which needs a little more skill but is worth the effort.This is my second case of the series.The first case was done more than a year ago and is still in my followup.Not sure what makes this graft work with those so called anatomical twists and turns around the bulbous part of urethra.Seems its the short length of the graft that does the trick.
