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

Area of Science:

• Vascular Surgery
• Radiology
• Trauma Surgery

Background:

• Isolated iliac artery aneurysms and gluteal artery aneurysms are exceptionally rare vascular conditions.
• Gluteal artery aneurysms typically involve the superior gluteal artery secondary to trauma or the inferior gluteal artery with pelvic fractures.

Observation:

• A 67-year-old male presented with a recurrent subcutaneous gluteal hematoma 28 days post-minor trauma.
• Initial endoscopic and surgical explorations failed to identify the bleeding source, despite multiple blood transfusions.

Findings:

• Contrast CT scanning was crucial in identifying two distinct internal iliac artery-associated bleeding points.
• Successful endovascular coil embolization was performed to treat both identified bleeding sources.

Implications:

• This case highlights a rare presentation of internal iliac artery aneurysms causing gluteal hematoma.
• It underscores the diagnostic challenge and the utility of advanced imaging like CT angiography in rare vascular emergencies.
• The successful endovascular management offers a valuable lesson for managing similar complex cases.