前田 英明, 根岸 七雄, 瀬在 幸安

Hideaki MAEDA, Nanao NEGISHI, Yukiyasu SEZAI

日本大学第2外科

Second Department of Surgery, Nihon University School of Medicine

キーワード : 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.