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CASE REPORT
Buttock wounds: beware what lies beneath
  1. Stephanie Clark1,
  2. Suzanne Westley1,
  3. Alexander Coupland1,
  4. Mohamad Hamady2,
  5. Alun H Davies1
  1. 1Academic Section of Vascular Surgery, Imperial College London, London, UK
  2. 2Surgery & Cancer, Imperial College London, London, UK
  1. Correspondence to Professor Alun H Davies, a.h.davies{at}imperial.ac.uk

Summary

A 25-year-old man presented to a major trauma centre with multiple stab wounds, most significantly to the right buttock. Triple-phase CT revealed no acute bleeding and his wounds were closed. In the month following injury, he re-presented seven times to the emergency department (ED) complaining of bleeding and wound breakdown. After his seventh ED attendance, he was examined under general anaesthesia. Intraoperatively, profuse arterial bleeding was encountered and the local major haemorrhage protocol was activated. The on-call consultant vascular surgeon attended and definitive control was achieved. A large haematoma had acted to tamponade ongoing arterial bleeding and an underlying pseudoaneurysm: a finding not reported, but present, on the initial CT angiogram. Following 24 hours in the intensive care unit, he was transferred to the surgical ward and discharged 4 days later. Regular review in the outpatient department over the following 9 weeks monitored successful wound healing.

  • vascular surgery
  • general surgery
  • interventional radiology

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Footnotes

  • Contributors SC, SW, AC, MH and AHD contributed to the design, drafting and final approval of the work.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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