Necrotizing Fasciitis Causing Complete Femoral Vessels Necrosis and Thrombosis in an Intravenous Drug Abuser: A Case Report

Majdi El Housseiny; Sirage Edriss; Talal  Kassar; Houssam Khodor Abtar; Jad J Terro

doi:10.38179/ijcr.v2i1.28

Authors

Majdi El Housseiny, MD Department of Surgery, Vascular Surgery Division, LAUMC-RH and Makassed General Hospital, Beirut, Lebanon
Sirage Edriss, MD Department of Surgery, Vascular Surgery Division, Makassed General Hospital, Beirut, Lebanon
Talal Kassar, MD Department of Surgery, Vascular Surgery Division, Makassed General Hospital, Beirut, Lebanon
Houssam Khodor Abtar, MD Department of Surgery, Makassed General Hospital, Beirut, Lebanon
Jad J Terro, MD Department of General Surgery, Faculty of Medical Sciences of the Lebanese University, Beirut, Lebanon

DOI:

https://doi.org/10.38179/ijcr.v2i1.28

Keywords:

Necrotizing fasciitis, intravenous drug abusers, rare case, case report, vascular surgery, ilio-femoral anastomosis

Abstract

Background: Intravenous drug abuse is an anciently known health and social problem worldwide. The nonsterile application of addicting drugs leads to severe life-threatening vascular complications. The femoral triangle is an easy target for this purpose. Groin necrotic fasciitis (NF) with vessel necrosis is a challenging diagnosis that requires prompt treatment.

Case Report: A 44-year-old male intravenous drug user presented for a left groin pain. He was diagnosed by computed tomography scan to have necrotizing fasciitis. Urgent debridement was performed and identified infected and necrotic ruptured femoral vessels without active bleeding. Debridement with vessel ligation was performed, and delayed revascularization was planned. The patient was admitted six weeks later with a left fifth toe necrosis and delayed arterial revascularization was performed via extra-anatomic trans-obturator ilio-femoral anastomosis. The patient had a favorable follow-up.

Conclusion: NF in intravenous drug abusers should always be taken into consideration when a patient presents with groin pain and swelling. Urgent surgical control should be established. Extra-anatomical trans-obturator ilio-femoral anastomosis is a good option for revascularization.

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