Aneurysmectomy and bypass grafting for a left profunda femoris artery aneurysm in a patient with situs inversus totalis

An 86-year-old man presented with lumbago and gait disturbance, initially attributed to T12 and L1 vertebral fractures. Contrast-enhanced computed tomography revealed a large left profunda femoris artery aneurysm measuring 56 × 70 mm, ascending aortic dilation, and situs inversus totalis. He underwent open aneurysm resection with revascularization using an autologous great saphenous vein graft. His gait disturbance resolved postoperatively, indicating that femoral nerve compression by the aneurysmal mass, rather than the vertebral fractures, was the cause of his symptoms. True profunda femoris artery aneurysms are rare, and their coexistence with situs inversus totalis is exceedingly uncommon.