Swelling in the Gluteal region

Abstract

A 70 years man presented with incapacitating
left calf Claudication and swelling
in the left gluteal region. Physical examination
revealed a 10cm x 8cm palpable
pulsatile mass over the left gluteal region
with palpable left femoral pulse and absent
popliteal pulse and ankle pulses.ABI
was1.01 on right side and 0.6 on left
side.C.T angiogram of the lower limbs
was performed from lower abdominal
aorta to both lower limbs ,Left lower limb
showed a persistent sciatic artery aneurysm
with a hypoplastic superficial femoral
artery coursing medially and tapering
as it proceeds to popliteal region. The
trifurcatin arteries were patent. The arterial
system on the right side were unremarkably
normal. The PSA was ligated
at the distal continuity using a medial
popliteal approach. Femoro popliteal bypass
using a 6mm PTFE graft was performed
to restore distal flow to the lower
limb .. Through a separate incision in the
left lower abdomen , ligation of posterior
division of internal iliac artery done after
therapeutic embolisation. Post operatively
the pulsatile mass reduced completely. The
patient recovered with palpable peripheral
pulses.A rare case, which presented as
pulsatile gluteal swelling.