Second Department of Surgery, Nihon University School of Medicine
Aneurysm, Color Doppler imaging, Persistent sciatic artery, ultrasonography
Aneurysms of the gluteal area are rare, usually occurring on persistently sciatic or arteriosclerotic gluteal arteries, or
developing after orthopedic surgery. A case of aneurysm accompanied by renal dysfunction in the left buttock is reported here.
A 65-year-old woman complaining of a mass of the left buttock, accompanied by severe pain and renal dysfunction, came to
this orthopedic service for consultation. Diagnosis with angiography and postcontrast CT scanning was extremely difficult
because of the renal dysfunction, and the orthopedist referred the patient to us for investigation of vascular disease.
Ultrasonography showed a 4.1×3.2 cm aneurysm with a mural thrombus. Color and pulsed Doppler imaging showed an
arterial pulsatile wave form that was accurately identified as the aneurysm. MRA subsequently showed the gluteal aneurysm
feeding from the internal iliac artery. A diagnosis of an aneurysm of the persistent sciatic artery was thus made. Doppler
ultrasonography no longer visualized the arterial pulsatile waveform after the level of pain subsided spontaneously over a 1-week
period. Color Doppler imaging was a useful, noninvasive means of identifying this gluteal aneurysm.