Jornal Vascular Brasileiro
http://www.jvascbras.org/article/doi/10.1590/1677-5449.003018
Jornal Vascular Brasileiro
Case Report

Pseudoaneurisma da artéria glútea inferior após queda de bicicleta: relato de caso

Inferior gluteal artery pseudoaneurysm after fall from a bicycle: case report

Renato Fanchiotti Costa, Ricardo de Alvarenga Yoshida, Rodrigo Jaldin Gibin, Marcone Lima Sobreira, Rafael Elias Fares Pimenta, Matheus Bertanha, Paula Angeleli Bueno de Camargo, Winston Bonetti Yoshida

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Resumo

Pseudoaneurysms of gluteal arteries are rare, especially involving the inferior gluteal artery. They are mainly associated with penetrating trauma, infections, or pelvic fractures. A minority of cases are caused by blunt traumas, with only six cases reported in English. We present a case of pseudoaneurysm of the right inferior gluteal artery after a bicycle fall, presenting with a large hematoma in the gluteal region, observed during clinical examination, and significantly reduced hemoglobin. CT angiography revealed a large hematoma, with contrast extravasation and pseudoaneurysm formation. Angiography revealed that the origin of the lesion was in the right inferior gluteal artery. This artery was embolized with coils. After the procedure, the patient was referred to an intensive care unit, from where he was later transferred to a different hospital, with bleeding controlled. Endovascular treatment of these cases is a safe, fast and an effective option.

Palavras-chave

buttocks/blood supply; aneurysm, false; wounds and injury; accidents, traffic

Abstract

Pseudoaneurismas de artérias glúteas são raros, especialmente os que envolvem a artéria glútea inferior. Eles estão associados principalmente a traumas penetrantes, infecções ou fraturas de pelve. Em uma minoria de casos, são causados por traumas fechados, havendo somente seis casos relatados na literatura. Apresenta-se aqui um caso de pseudoaneurisma da artéria glútea inferior direita após queda de bicicleta, evoluindo com grande hematoma na região glútea ao exame clínico e queda hematimétrica significativa. A angiotomografia revelou um grande hematoma na região glútea, com extravasamento de contraste e formação de pseudoaneurisma no local. A angiografia revelou que a origem da lesão era na artéria glútea inferior direita. Foi realizada embolização dessa artéria com molas. Após esse procedimento, o paciente foi encaminhado para a unidade de terapia intensiva, de onde foi posteriormente transferido para outro hospital, com o sangramento controlado. Para esses casos, o tratamento endovascular é uma opção segura, rápida e efetiva.

Keywords

nádegas/irrigação sanguínea; falso aneurisma; ferimentos e lesões; acidentes de trânsito.

References

1. Saad PF, Saad KR, Armstrong DM, Soares BL, de Almeida PH, Razuk Á Fo. Inferior gluteal artery pseudoaneurysm related to intramuscular injection. Int J Case Reports. 2015;6:29-32. PMid:25506847.

2. Zhang Q, Liu H, Smith WR, Pan J, Chen W, Zhang Y. Blunt injury to the inferior gluteal artery: case report of a rare “near miss” event. Patient Saf Surg. 2008;2(1):27. http://dx.doi.org/10.1186/1754-9493-2-27. PMid:18959806.

3. Babu A, Gupta A, Sharma P, Ranjan P, Kumar A. Blunt traumatic superior gluteal artery pseudoaneurysm presenting as gluteal hematoma without bony injury: a rare case report. Chin J Traumatol. 2016;19(4):244-6. http://dx.doi.org/10.1016/j.cjtee.2015.11.018. PMid:27578385.

4. Taif S, Derweesh A, Talib M. Superior gluteal artery pseudoaneurysm presenting as a gluteal mass: case report and review of literature. J Clin Imaging Sci. 3:49. http://dx.doi.org/10.4103/2156-7514.

5. Corbacioglu KS, Aksel G, Yildiz A. Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report. Turk J Emerg Med. 2016;16(1):26-8. http://dx.doi.org/10.1016/j.tjem.2015.10.002. PMid:27239635.

6. Bennett JD, Brown TC, Coates CF, MacKenzie D, Sweeney J. Pseudoaneurysm of the inferior gluteal artery. Can Assoc Radiol J. 1992;43(4):296-8. PMID: 1638430.

7. Aydin A, Lee CC, Schultz E, Ackerman J. Traumatic inferior gluteal artery pseudoaneurysm: case report and review of literature. Am J Emerg Med. 2007;25(4):488.e1-3. http://dx.doi.org/10.1016/j.ajem.2006.11.015. PMid:17499680.

8. Battle WH. Case of traumatic gluteal artery aneurysm. BMJ. 1898;2:1415.

9. Agarwal M, Giannoudis PV, Syed AA, Hinsche AF, Matthews SJ, Smith RM. Pseudoaneurysm of the inferior gluteal artery following polytrauma: diverse presentation of a dangerous complication: a report of two cases. J Orthop Trauma. 2003;17(1):70-4. http://dx.doi.org/10.1097/00005131-200301000-00013. PMid:12499973.

10. Dongola NA, Giles JA, Guy RL. Embolisation of a post-traumatic superior gluteal artery aneurysm: case report. East Afr Med J. 2004;81(8):433-5. http://dx.doi.org/10.4314/eamj.v81i8.9207. PMid:15622940.

11. Mouawad NJ, Haurani MJ, Mason T, Satiani B. Delayed presentation and management of blunt traumatic inferior gluteal artery pseudoaneurysm with associated arteriovenous fistula. Vasc Endovascular Surg. 2013;47(7):573-6. http://dx.doi.org/10.1177/1538574413497272. PMid:23883787.

12. Zhang Q, Chen W, Smith WR, Pan J, Liu H, Zhang Y. Superior gluteal artery injury presenting as delayed onset shock. Arch Orthop Trauma Surg. 2010;130(2):251-6. http://dx.doi.org/10.1007/s00402-009-0916-7. PMid:19533156.

13. Vauthey JN, Maddern GJ, Balsiger D, Blumgart LH, Triller J. Superselective embolization of superior gluteal artery pseudoaneurysms following intramuscular injection: case report. J Trauma. 1991;31(8):1174-5. http://dx.doi.org/10.1097/00005373-199131080-00020. PMid:1875445.

14. Keeling AN, Naughton PA, Leahy AL, et al. Traumatic inferior gluteal artery pseudoaneurysm and arteriovenous fistula managed with emergency transcatheter embolization. Cardiovasc Interv Radiol. 2008;31:S135-9. http://dx.doi.org/10.1007/s00270-007-9150-2. PMID: 17710471.

15. Kuzuya A, Fujimoto K, Iyomasa S, Matsuda M. Transluminal coil embolization of an inferior gluteal artery aneurysm by ultrasoundguided direct puncture of the target vessel. Eur J Vasc Endovasc Surg. 2005;30(2):130-2. http://dx.doi.org/10.1016/j.ejvs.2005.03.006. PMid:15890542.

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