SUPERIOR GLUTEAL ARTERY PSEUDOANEURYSM: TWO CASES REPORT AND REVIEW OF THE LITERATURE

Abstract

Introduction: Gluteal pseudoaneurysms are extremely rare and respond to pelvic trauma, penetrating wounds, inflammation or infection in the gluteal region.

Clinical cases: Two men, 73 and 82 years respectively, who presented gluteal pseudoanerysm after drainage of perianal abscess the first one and after trauma the second one. In both cases the diagnosis was made by imaging tests (doppler ultrasound that was completed with computed tomographic angiography). The first one was successfully treated by ultrasound-guided injection of thrombin at the pseudoaneurysm sac. However, secondary treatment with thrombin injection and coil embolization was performed due to pseudoaneurysm reperfusion. The second one was successfully treated by embolization with hydrocoils through contralateral percutaneous femoral access as well as thrombin injection by direct ultrasound-guided puncture.

Discussion: The incidence, presentation and surgical strategy are discussed. Current literature is also reviewed.

Conclusion: Ultrasound scan is the first diagnostic test, computed tomographic angiography can give more topographic information. We found selective percutaneous embolization to be the treatment of choice. Open surgical treatment should be reserved for selected cases.