Recurrent gluteal haematoma: two internal iliac artery-associated bleeding points.
Isolated iliac artery aneurysms are extremely rare. 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. We discuss a diagnostically challenging presentation of recurrent subcutaneous gluteal haematoma due to two separate internal iliac artery-associated bleeding points. A 67-year-old man was referred, from a peripheral hospital, with a right-sided subcutaneous gluteal haematoma. This manifested 28 days following minor non-penetrating, non-fracture-associated trauma. Despite repeat blood transfusions, albeit interspersed with days of haemodynamic stability, and despite exclusion of relevant bleeding sources at endoscopy and two surgical explorations, it was only until contrast CT scanning was requested that both bleeding sources were identified and successfully treated by endovascular coil embolization. This provides an important variant and lesson to supplement current literature and understanding of more diagnostically challenging cases of an extremely rare presentation.
Plastic & Reconstructive Surgery Department, Chelsea and Westminster Hospital, 369 Fulham Road bilalrafique90@hotmail.com.
Bilal
B
Rafique
Plastic & Reconstructive Surgery Department, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond Street, London NW3 2QG.
Benjamin H
BH
Miranda
Plastic & Reconstructive Surgery Department, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond Street, London NW3 2QG.
Esha L
EL
Gopee
Interventional Radiology Department, Royal Free London NHS Foundation Trust.
Andrew J
AJ
Wigham
Plastic & Reconstructive Surgery Department, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond Street, London NW3 2QG.
Neil J
NJ
Toft