Inferior gluteal artery pseudoaneurysm mimicking gluteal abscess

Abstract

We report a case of pseudoaneurysm of inferior gluteal artery initially diagnosed as gluteal abscess. Pseudoaneurysms of inferior gluteal artery are rare. High degree of clinical suspicion is required in a patient presenting with a post-traumatic swelling in the gluteal region. These aneurysms may present with very different clinical pictures. They can be diagnosed by Doppler ultrasound, computed tomography or magnetic resonance imaging. Mainstay of the diagnosis is by angiography and the preferred management with good clinical results is with angiographic embolisation.

Recurrent gluteal haematoma: two internal iliac artery-associated bleeding points

“…They may be slow-growing and present late either as an incidental finding or with gluteal swelling and bruising, compressive neuropathy or compression of surrounding structures. Differential diagnosis should include a gluteal abscess and gluteal compartment syndrome [ 5 – 7 ]. Radiological investigations including duplex, CT and MRI may facilitate bleeding course identification, shape, size and position relative to surrounding structures.…”

“…Gluteal artery aneurysms are also rare, more commonly affecting the superior gluteal artery in association with penetrating trauma, with those of the inferior gluteal artery usually associated with pelvic fractures [ 3 , 4 ]. Although often asymptomatic, presentations may include progressive gluteal swelling, a mass mimicking a gluteal abscess, a tumour or be associated with sciatic nerve compression symptoms [ 5 ].…”

Inferior gluteal artery pseudoaneurysm related to intramuscular injection

“…9 A delay in onset increases the likelihood of erroneously diagnosing other conditions, such as a gluteal abscess, sarcoma, lipoma, or hernia. 4,10,11 In at least two patients with an uncertain diagnosis who underwent an open surgical procedure to drain a putative abscess or hematoma, disastrous hemorrhage and shock developed intraoperatively. 4,10,12 …”

“… 1 In 17 reports of IGA pseudoaneurysms in the past three decades, the causes ranged from blunt or penetrating trauma, infection, fractures of the pelvis or iatrogenic injury during surgical procedures on the pelvis or hips. 1–6 We describe a case of pseudoaneurysm of the IGA following intramuscular injection of medication in the buttock. Our report highlights the importance of considering arterial pseudoaneurysms in the differential diagnosis of post-traumatic swelling in the gluteal region, and we review the relevant literature.…”

Delayed Presentation and Management of Blunt Traumatic Inferior Gluteal Artery Pseudoaneurysm With Associated Arteriovenous Fistula

“…The use of covered stents have also been employed in the management of vascular injuries associated with pseudoaneurysms and arteriovenous fistulae with acceptable success. 19 The use of minimally invasive techniques has several distinct advantages over traditional open surgery. First, there is less hemodynamic stress on patients from the surgical wound and general anesthesia, especially the elderly patient with multiple medical comorbidities; second, the retroperitoneum is not opened; third, the risk of infection is greatly reduced; and fourth, the tamponade effect of the hematoma is not released.…”