Lycanthropy is an unusual belief or delusion that one has been transformed into an animal, or behaviors or feelings suggestive of such a belief. We report a case of lycanthropic delusions of becoming a snake in a 47-year-old woman who suffered from a major depressive disorder with psychotic features. We also present a literature review of articles published on the subject in English or French since 1975 identified via a MedLine search using the terms "lycanthropy" or "werewolf." Many case reports have described lycanthropy as a delusional disorder occurring acutely in patients who think they suffer from a demonic possession as a punishment for their acts. In these cases, symptoms are generally rapidly reversible. Lycanthropy seems to be a nonspecific manifestation of many psychiatric diseases, most commonly major depressive disorder with psychotic features. It is largely influenced by the cultural environment of the patient so that the animal species frequently represents the patient's delusional representation of evil. Lycanthropy could be considered a culture-bound syndrome that occurs in association with Axis I, DSM-IV psychiatric pathology.

A 70-year-old man presented with a painless pulsatile mass at the right iliac fossa that he had first noticed 2 years earlier. In 2012, a right axillobifemoral bypass graft was performed to treat severe occlusive aortoiliac disease. At that time, the patient had severe chronic obstructive pulmonary disease, severe abdominal obesity, and heavily calcified abdominal aorta that contraindicated aortobifemoral surgery. A 50-cm-long 8-mm ringed polytetrafluoroethylene (PTFE) graft was used from the right axillary to the right femoral artery. Once the axillary anastomosis was completed, the graft was found to be short. A second PTFE graft was therefore added in an end-to-end fashion to reach the femoral artery, followed by a femorofemoral bypass.Physical examination showed no signs of infection, and there was no history of direct trauma to the right iliac fossa. The right and left femoral pulses were present. A computed tomography scan revealed a pseudoaneurysm at the site of the graft-to-graft anastomosis (A).An incision was made directly over the mass. After proximal and distal vascular control, the pseudoaneurysm was incised and showed classic thick fibrous tissue. Complete disruption of the anastomosis was noted, and both ends were 6 to 7 cm apart. An 8-mm PTFE graft was used in an end-to-end fashion. The postoperative course was uneventful. The cultures came back negative. An informed consent was obtained from the patient.

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