1Anoosha Aslam, 1Vikram Puttaswamy
1Royal North Shore Hospital, Sydney, Australia
Popliteal aneurysms are defined as a focal dilatation of the popliteal artery more than 50% of the vessel diameter. Popliteal aneurysms are known to be associated with atherosclerosis, smoking and connective tissue disorders. Symptomatic popliteal aneurysms require surgical intervention due to the risk of developing thrombosis and acute limb ischemia.
We present a rare case report involving Mr XY, a 76 year old gentleman who presented with right lower limb pain on a background of ischemic heart disease, hypertension and dyslipidemia. He underwent imaging of the right lower limb demonstrating a right popliteal saccular aneurysm measuring 3.5 cm in size with surrounding fluid collections. Mr XY subsequently underwent endovascular stenting procedures (using covered stents) for this and was discharged. He re-presented with right thigh pain/ swelling, and was found to have enlarged collections in his surrounding soft tissues. These collections were aspirated by interventional radiology and sent for further investigation.
Acid fast bacilli were seen in the fluid microbiology and PCR was positive for mycobacterium complex. Mr XY was thought to have a disseminated tuberculous infection which was associated with the formation of the popliteal aneurysm and eventually multiple large surrounding collections.
This is a rare case of patient developing not only a significant aneurysm, but also multiple collections in the context of disseminated tuberculous infection.