A MASSIVE THIGH HEMATOMA FROM FEMORAL ACCESS: A CHALLENGE IN A RESOURCE-LIMITED CENTER
Oguamanam O. Enwere* and Ernest N. Anyabolu
Background: Repeated femoral cannulations may lead to aneurysm, hematoma and sepsis. Very extensive thigh hematoma needing vascular reconstruction are rare. But would pose a challenge in a human and material resource-limited setting. Findings: The patient was a 54year-old woman who has ESRD from ADPKD and was on maintenance hemodialysis. She could not obtain an A-V fistula because the nearest center that offered it was dysfunctional at the time. Following repeated femoral cannulations from different dialysis centers, she developed a massive right thigh hematoma and subsequently an extensive thigh wound sepsis. Nevertheless, following conservative management by the Surgery Unit, the wound made a remarkable progressive healing. However, she later died of uremia as she could no longer afford the cost of maintenance dialysis. Conclusion: This case of a massive thigh hematoma and an extensive thigh wound sepsis in an ESRD patient on maintenance hemodialysis shows the challenge of the risk of hematoma and sepsis and in the event of indication for reconstructive vascular surgery.
Keywords: Femoral cannulation, thigh hematoma, wound sepsis, hemodialysis, ESRD, Nigeria.
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