Superior Gluteal and Inferior Gluteal Artery Pseudoaneurysms Following Blunt Traumatic Pelvic Ring Disruption

We present a case of a previously healthy man arriving at our emergency department complaining of pelvic and lower extremity pain after being crushed by a fork lift at work. A computed tomography (CT) revealed significant pelvic ring disruption with 100% disassociation of the sacroiliac (SI) joint, along with a transverse posterior wall fracture pattern and displacement hip protrusion. The patient underwent staged open reduction and internal fixation of his injuries. Twenty two days after the initial injury, he developed hemodynamic instability, CT revealed active extravasation of contrast in the pelvis. Angiography subsequently revealed unique pseudoaneurysms of the superior and inferior gluteal arteries. Embolization of the pseudoaneurysms was complicated with subsequent gluteal muscle necrosis.