2020 Military Poster Presentations

Yaser S Selim, MD, MRCS, Hasan Yahia Sahabi, Consultant; Ministry of Health, Kingdom of Saudi Arabia

Penetrating gluteal injuries are life-threatening; yet few publications on this topic have been reported in the Anglo-American literature in the past 15 years. Data from a prospective study demonstrate that major life threatening visceral and vascular injuries occur in 29% of patients who sustained GSW. The rate of this kind of injuries requiring surgical intervention has been reported to be 27% to 49%. We report a patient who presented with gunshot wound injury to the right buttock with massive bleeding and late presentation which added to the severity of hypovolemia. Gunshot involves the upper part of the gluteal region continuous bleeding in spite of using manual compression and gauze packing. After a trial of local exploration by an orthopedic surgeon, general surgeon has been called for opinion and vascular management of suspected vascular injury, namely injury to the superior gluteal artery. Immediate laparotomy done with ligation of the internal iliac artery. Patient’s vital status improved and patient survived

In conclusion, internal iliac artery ligation can be a life-saving procedure in extensive gunshot injuries to the buttock, with severe bleeding and hemodynamic instability in absence of angiographic facility, especially in rural areas.

Key words: penetrating injury, buttock, gunshot