Article Details

Introduction: Vascular injury after proximal femoral fracture fixation is uncommon, and Superior Gluteal Artery (SGA) involvement is extremely rare. We report a case of SGA pseudoaneurysm following intramedullary nailing to highlight the diagnostic and management challenges of this life-threatening complication.

Case Presentation: A 68-year-old male developed persistent anemia following Gamma nail fixation for a trochanteric fracture. CT angiography revealed a 2cm SGA pseudoaneurysm, initially treated with percutaneous thrombin injection. Due to recurrence, a second procedure on POD29 combined thrombin with percutaneous microcoil embolization, achieving technical success. Despite hemoglobin stabilization, the patient had a complicated course and succumbed to cardiac arrest on POD36.

Conclusion: SGA pseudoaneurysm is a rare but critical complication. Its indolent presentation warrants a high index of suspicion for unexplained postoperative anemia, prompting prompt CT angiography. Vigilance for recurrence is essential even after a technically successful intervention.

Keywords: Aneurysm; False; Gluteal arteries; Fracture fixation; Intramedullary nail; Postoperative complications; Embolization