Hypovolemic shock caused by delayed-onset superior gluteal artery rupture, successfully treated with arteriographic embolization

Abstract

Introduction: Rupture of the superior gluteal artery (SGA) is usually associated with pelvic bone fractures and acetabular fractures secondary to blunt trauma. However, despite recent advances in technologies and tools, rupture of the SGA remains a challenging problem because it is difficult to manage and is frequently associated with significantly high mortality and morbidity.

Patients and methods: We present a case of an 82-year-old man, who presented to our emergency department after a cultivator turnover accident and who showed stable initial vital signs and manifested only as blunt buttock traumatic contusion without any pelvic bone or acetabular fracture, which resulted in delayed massive bleeding from the SGA on eight days after trauma.

Results: A hypovolemic shock and abrupt 4.2 g/dl hemoglobin decrease caused by massive bleeding from delayed-onset SGA rupture, was successfully treated with urgent angiographic embolization.

Conclusions: A delayed SGA bleeding should be considered in late-onset shock associated with blunt buttock trauma. Furthermore, early detection and embolization not only prevent further complications, such as compartment syndrome and hypovolemic shock, but also eliminate the need for any surgical interventions.

Keywords:

• Angiography
• embolization
• superior gluteal artery

Acknowledgments

This paper was written as part of Konkuk University's research support program for its faculty on sabbatical leave in 2016.

Disclosure statement

No potential conflict of interest was reported by the authors.