The Femoral Gateway
The Femoral Gateway
A patient who abused cocaine intravenously had an abscess in the groin, which healed to form a sinus tract leading directly to the wall of the femoral vein. She used this gateway as her primary means of venous access for the next 5 years. It was both painless and brainless and led to femoral vein thrombosis and sepsis. This is the second reported case of such a unique means of venous access.
The intravenous (IV) drug abuser is a familiar and frequent visitor to hospitals, often for reasons related to trauma or overdose, but also because these abusers have a propensity for infections. In the subspecialty of infectious diseases, IV drug abusers hold a special place, almost a fond and familiar place. The sharing of needles predisposes them to blood-borne diseases such as human immunodeficiency virus (HIV), hepatitis C, malaria, and syphilis. Injection through skin and into the vein predisposes them to abscesses, cellulitis, thrombosis, septic emboli, endocarditis, and even tetanus. Their addiction results in their being just as committed to the method of drug use as they are to the drug.
A frequent problem encountered by the IV drug abuser is venous access. When the antecubital vein and other superficial and accessible veins become thrombosed, patients may resort to neck veins, leg veins, and even unusual sites such as the dorsal vein of the penis. We describe a patient who, by happenstance and as a result of a past infection, developed a unique means of venous access. She is the second patient with this form of access seen by one of us in the course of 15 years.
A patient who abused cocaine intravenously had an abscess in the groin, which healed to form a sinus tract leading directly to the wall of the femoral vein. She used this gateway as her primary means of venous access for the next 5 years. It was both painless and brainless and led to femoral vein thrombosis and sepsis. This is the second reported case of such a unique means of venous access.
The intravenous (IV) drug abuser is a familiar and frequent visitor to hospitals, often for reasons related to trauma or overdose, but also because these abusers have a propensity for infections. In the subspecialty of infectious diseases, IV drug abusers hold a special place, almost a fond and familiar place. The sharing of needles predisposes them to blood-borne diseases such as human immunodeficiency virus (HIV), hepatitis C, malaria, and syphilis. Injection through skin and into the vein predisposes them to abscesses, cellulitis, thrombosis, septic emboli, endocarditis, and even tetanus. Their addiction results in their being just as committed to the method of drug use as they are to the drug.
A frequent problem encountered by the IV drug abuser is venous access. When the antecubital vein and other superficial and accessible veins become thrombosed, patients may resort to neck veins, leg veins, and even unusual sites such as the dorsal vein of the penis. We describe a patient who, by happenstance and as a result of a past infection, developed a unique means of venous access. She is the second patient with this form of access seen by one of us in the course of 15 years.
