Pseudoaneurysm of the superior gluteal artery following iliosacral screw fixation – a case of non-operative treatment with spontaneous recovery

Abstract

We present a case of superior gluteal artery pseudoaneurysm following iliosacral screw placement into the posterior pelvis in a patient with vertically unstable pelvic fracture (OTA/AO 61C2.3(b,k)) who received anticoagulant therapy for deep venous thrombosis. The primary complaint was that of neuropathic pain the patient developed on the fourth postoperative day due to sciatic nerve irritated by a mass in the gluteal region. CT demonstrated intermuscular haematoma that was conservatively treated with analgesics, anticonvulsants, and antispasmodics. The therapy resulted in moderate positive effect. The gluteal mass was noted to grow at three months postsurgery. Ultrasonography showed turbulent blood flow inside the haematoma cavity and a diagnosis of pseudoaneurysm of the superior gluteal artery was made. Further observation revealed spontaneous decrease in the volume of pseudoaneurysm cavity and complete resolution at 5 months of surgery, and pain completely relieved at the time. No operative procedure was required for the pseudoaneurysm.