Eight cases of life-threatening sequelae of relatively minor penetrating injuries of the gluteal region, involving the gluteal or internal pudendal arteries, are reported. The modes of presentation included exsanguinating external hemorrhage (two), acute false aneurysm (one), and chronic false aneurysm (five). Failure to appreciate the nature of the lesion led to inappropriate initial management in seven instances. This series emphasizes the danger of direct incision of lesions in this region which are suspected of being abscesses that are in fact false aneurysms (“pulsatile abscesses”) and demonstrates the need for a high index of suspicion for problems related to these vessels following penetrating trauma to the gluteal region, even if seemingly minor, and the need for adequate investigation and planning before surgery.
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