Abstract
Introduction
Thrombin injection for the treatment of arterial pseudoaneurysms has been performed safely and effectively for many years. These pseudoaneurysms typically develop after a performance of a percutaneous procedure that uses the common femoral artery for access. This technique has also been applied effectively for pseudoaneurysms arising from other arteries. This report presents the first use of thrombin injection technique with ultrasound guidance for ablation of a gluteal pseudoaneurysm.
Case Report
A 44-year-old man presented with complicated diverticulitis and was treated with two operations. Afterward, he had an infected pelvic fluid collection that was drained with computed tomography-guided, trans-gluteal approach. After drain removal, pain developed in the right buttock, and a gluteal pseudoaneurysm was diagnosed, which was successfully treated with an ultrasound-guided, thrombin injection.
Conclusions
Complications resulting from trans-gluteal drainage are unusual. Pain and hemorrhagic complications have been documented and are more common when a transpiriformis muscle approach is mandated by location of the fluid collection. Thrombin injection provided a rapid, safe, and effective treatment for this complication. This approach required no significant anesthesia and recovery was less than 2 days. Ultrasound demonstrated clearly that the gluteal fluid collection was a pseudoaneurysm and that it demonstrated characteristics favorable for thrombin injection.
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